CMS Administrator Seema Verma has expressed frustration with the slow pace at which health care providers are assuming financial risk under alternative payment models, and HHS Secretary Alex Azar said that accelerating the transition to value-based care is among his top priorities. Both indicated a willingness to allow health care providers to leave the Medicare Shared Savings Program, and Azar said they are considering offering direct contracts between health care providers and Medicare.
The CMS has granted Maryland approval to expand its all-payer health care reimbursement model through 2023, with the option to renew it for another five years thereafter. The current all-payer model, which is expected to save Medicare $300 million per year by 2023, exempts the state from typical Medicare regulations and allows it to set its own hospital reimbursement rates, with physician offices and nursing homes allowed to voluntarily participate beginning Jan. 1.
The Federal Communications Commission should increase the annual spending cap for the Rural Health Care Program, which provides funding to support telemedicine services in rural communities, beyond its current level of $400 million, a bipartisan group of 31 senators wrote in a letter. "Unless the spending cap is raised appropriately to account for current needs and future growth, health care providers in rural areas will encounter severe rate increases for their broadband services, making it even harder for rural health care practitioners to engage in life-saving telemedicine," the letter states.
The OneCare Vermont initiative, which allocates a set amount of money for participating providers to cover services for all patients in the program, is increasing its scope of coverage in the state and is being considered by other states as a way to reduce costs and keep people healthy. The organization came within 1% of its financial goals in its first year, and while it covers about 18% of the state's population, the goal is to cover 70% of health care services provided in the state.
A new outpatient center at NewYork-Presbyterian and Columbia University Irving Medical Center is offering team-based coordinated care for patients with high-risk pregnancies. The center offers counseling, telemedicine, integrated postnatal care and research.
New York's North Shore University Hospital is using data and technology to identify where HIV is more prevalent in Long Island and Queens. The hospital has a program that includes social workers, nurse case managers, health educators and dietitians, but officials want to see if everyone is benefiting equally.
A study in the Annals of Family Medicine found that individuals whose Mini-Mental State Examination scores dropped by at least 2 points over two years were more likely to develop dementia, while an even higher dementia risk was found among those who also had imperfect Visual Association Test scores. Researchers suggest that VAT "may help distinguish older adults who need further cognitive examination from those in whom a watchful waiting policy is justified."
An analysis of data on 75 adults who were overweight or obese found that those who participated in one of two habit-based weight-loss intervention programs lost more weight than the control group and improved body mass index, weekly exercise rates and reported well-being, anxiety and depression from baseline. The researchers reported in the International Journal of Obesity that 65% of participants in the intervention groups reduced body weight by at least 5% from baseline.
The Medicare Diabetes Prevention Program, which was established to help prevent the progression of prediabetes by educating patients about the benefits of increased physical activity, long-term dietary changes and behavior-change strategies for weight control, builds on success seen in a CDC program often covered by private payers. Participants in Medicare's prevention program must be enrolled in Medicare Part B; have no diagnosis of type 1 diabetes, type 2 diabetes or end-stage kidney disease; have a body mass index of at least 25; and have had an abnormal blood glucose reading within 12 months of the start of the first session.
At Institute & Expo you'll enjoy insights, ideas, and lightbulb moments. Explore alternative payment models, outcome-based specialty drug contracting, value-based insurance design, and other tactics that support the move from volume- to value-based care. You'll explore aligning multiple stakeholder incentives, challenges implementing various models, and whether current benchmarks will effectively drive quality. Register today.