January 25, 2022
AHIP Solutions SmartBrief
Top Stories
Senators: Medicare should cover home COVID-19 tests
(Phil Walter/Getty Images)
A coalition of 19 Senate Democrats wrote a letter to CMS and HHS leaders calling for Medicare to cover the cost of home COVID-19 tests for older people and those with disabilities, just as commercial health insurers are doing for their members. It's not clear which part of Medicare would cover the home tests, but the lawmakers argued that those "enrolled in Medicare are at the highest risk of severe illness from COVID-19. ... The current policy leaves them on the hook for potentially significant out-of-pocket costs."
Full Story: FierceHealthcare (1/24),  National Public Radio (1/24) 
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A study conducted by Cigna found patients using virtual care can save an average of $93 per visit on nonurgent care, an average of $120 on specialist care and up to $141 per visit on urgent care. The analysis, based on data from Cigna's telehealth unit MDLive, found use of virtual care was associated with 19% fewer emergency department or urgent care visits, while virtual urgent care visits lowered the duplication of care 16% compared with visits to other virtual care providers.
Full Story: Becker's Payer Issues (1/21),  FierceHealthcare (1/21) 
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Only 25% of Members Trust Their Plans
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Providers & Suppliers
A survey of more than 13,000 US physicians from 29 areas of specialty indicated that many are dealing with high levels of stress and feelings of burnout. Overall, 47% of physicians said they were affected by burnout over the last year, compared to 42% a year ago.
Full Story: Medscape (free registration) (1/21) 
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Is Your FHIR® API for CMS Compliance Actually Working?
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Medical Update
Fauci: Omicron surge could peak by mid-February
Fauci. (Pool/Getty Images)
COVID-19 case numbers appear to be heading in the right direction, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who said he expects Omicron variant cases to have peaked in most states by mid-February. Nationwide, COVID-19 cases for the past seven days are down 12% from the previous week, but average COVID-19-related deaths have reached 2,200 per day, up 11% from the prior week and the highest in 11 months.
Full Story: ABC News (1/23),  Reuters (1/24) 
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Children who previously had COVID-19 were up to 2.5 times more likely to be diagnosed with diabetes, according to an analysis of more than 2 million US children published in Morbidity and Mortality Weekly. "Nearly half had diabetic ketoacidosis at time of diabetes diagnosis, a serious diabetes complication, at a much higher rate than previously reported," said researcher Sharon Saydah.
Full Story: Healio (free registration)/Endocrine Today (1/21) 
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Emerging Trends: Social Determinants of Health
Financial aid may influence infant brain function
Research published in the Proceedings of the National Academy of Sciences found 1-year-old babies with low-income mothers who had received $333 per month in cash aid for a year demonstrated more of a type of brain activity linked with stronger cognitive development, compared with infants whose mothers received $20 per month. "This is the first study to show that money, in and of itself, has a causal impact on brain development," according to Dr. Kimberly Noble, who helped lead the research.
Full Story: The New York Times (1/24) 
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US Census Bureau data show that people in more socioeconomically vulnerable demographics had higher rates of preventable emergency department visits from 2013 to 2017. Risk factors for preventable visits included education, income, insurance coverage, employment status, and access to transportation and the internet.
Full Story: US Census Bureau (1/20) 
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Federal statistics indicate that 3.5 million Americans age 65 and older had trouble affording their prescription medications in 2019. The data also showed that Medicare enrollees of color and people in lower-income groups were more likely to miss doses of necessary medications because of cost concerns.
Full Story: AARP (1/19) 
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The No Surprises Act is Here - Is Your Provider Data Ready?
Your provider data needs to be correct and up to date, but getting the information doesn't have to be challenging. Turn to HGS Healthcare for a complete set of services and solutions. Find out more.
Health Insurance Provider Company News
As COVID-19 Looms, Credentialing Providers Has Become Increasingly Challenging
We know firsthand what Credentialing Departments in health plans are grappling with; being asked to do more, with less, and in some cases having to do it with an abbreviated staff - indefinitely. Add to that overburdened providers, your team may be experiencing credentialing timelines extending as much as 90-days. Download the webinar to learn how we are assisting health plans.
Solutions Provider News
Pharma News
The FDA said Monday that it will limit the use of monoclonal antibody drugs for COVID-19 manufactured by Regeneron Pharmaceuticals and Eli Lilly and Co., as evidence suggests they are not effective against the Omicron variant of the coronavirus. The agency did not revoke emergency use authorization but said the treatments should only be used in cases involving a coronavirus variant that is vulnerable to the drugs.
Full Story: The Hill (1/24) 
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Policy Watch
Conditions are ripe for the emergence of another SARS-CoV-2 variant that threatens global public health, and world leaders should continue pressing vaccination and prevention efforts, says World Health Organization Director-General Tedros Adhanom Ghebreyesus. The Omicron variant appears to be more contagious but less lethal than previous variants of concern, leading to some optimism that the pandemic may burn itself out, but Tedros cautions that such thinking is dangerous.
Full Story: Reuters (1/25) 
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What's next for your members and the communities you serve? Find it at AHIP 2022. (Formerly Institute & Expo.) Health care's essential event has a new name that prioritizes what's next, now. Experience the right mix of expert sessions, meaningful networking, and solution-finding. See all your reasons to start planning for June 21 through 23 in Las Vegas. Learn more.
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Senior voters are overwhelmingly satisfied with Medicare Advantage, and 3 out of 4 want the federal government to protect MA funding, according to recent polling from the Coalition for Medicare Choices. The polling found that 93% of senior voters are satisfied with their MA coverage, and 96% would recommend it to family and friends. CMC also released a new infographic highlighting member satisfaction with several benefits, from wellness programs to dental care to capping out-of-pocket costs.
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