Medicare Advantage, costs of drugs, post-acute care shaping payment reform | Biosimilars crucial to success in value-based cancer care | CMS relaxes Medicaid restrictions on inpatient mental health treatment
November 14, 2018
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Accountable Care Spotlight
Medicare Advantage, costs of drugs, post-acute care shaping payment reform
Critical trends that are not receiving enough attention in discussions of value-based care include integration of drug costs into payment models, the increasingly pivotal role Medicare Advantage plays in payment delivery and innovation, and optimization of post-acute care, writes Avalere Health Vice President Fred Bentley.
U.S. News & World Report (11/13) 
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Biosimilars crucial to success in value-based cancer care
Lower-cost biosimilar versions of biologic drugs are expected to reduce spending and increase access to drugs for cancer and supportive care, according to a review published in Cancer Management and Research. The CMS is running demonstration projects under the Medicare Shared Savings Program and the Oncology Care Model in which biosimilars could reduce spending and improve efficiency, the authors wrote.
The American Journal of Managed Care online (11/8) 
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CMS relaxes Medicaid restrictions on inpatient mental health treatment
The CMS sent a letter to state Medicaid directors Tuesday urging states to apply for new waivers enabling expanded coverage of inpatient care at institutions of mental disease. The waiver will apply to all Medicaid beneficiaries, not just those in managed care, and will allow for 30 days of care for severe mental illness.
Modern Healthcare (tiered subscription model) (11/13),  The Hill (11/13) 
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CVS eyes focus on value as acquisition nears completion
CVS Health's acquisition of Aetna is expected to close soon, and Larry Merlo, CVS Health CEO, announced plans to reduce costs and improve patient health through medication adherence programs, alternatives to emergency department care and careful management of chronic conditions. CVS will expand specialty infusion services through its Coram division, available in home and outpatient care settings.
MedCity News (11/12) 
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Overcoming barriers with wearables and health coaching
According to a recent survey, hospitals and health systems are no longer questioning the value, or desire, for Patient-Generated Health Data. In fact, they are demanding it. Learn what this survey discovered about wearables, health coaching and chronic condition management, and what the future holds for PGHD and wearables. Download now.
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Insight into Health Care Quality
Adding care quality measures to QPP may help reduce health care costs
A study in the Annals of Family Medicine found patients spent 14.1% less on health care costs and had 16.1% lower odds of hospitalization when they received care from physicians with the highest continuity of care scores, compared with those who visited physicians with the lowest scores. Researchers evaluated Medicare claims data for 1,448,952 beneficiaries and recommended adding continuity of care-related quality measures to the Quality Payment Program and reducing focus on process-based measures in federal reporting requirements.
EHR Intelligence (11/13) 
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The Technology Component
Cigna expands behavioral health program with new digital tools
Cigna announced that it will be offering Happify Health and iPrevail's digital resources to employers as part of the company's behavioral health program starting in January. Happify offers personalized activities and guided meditations to support emotional health, while iPrevail has a private chat platform offering personalized mental health care guidance for people experiencing stress, depression and other mental health issues.
Healthcare Finance (11/12) 
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Health tech CEOs join effort to push Medicaid innovation
HealthTech4Medicaid is a new nonprofit group that includes about 40 health technology company CEOs who want to speed technology innovation to improve care for Medicaid recipients. The group represents more than $1 billion in venture capital, and its goals include increasing access to care, improving quality and decreasing costs.
Health Data Management (free registration) (11/13) 
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Population Health and Patients
Even small bursts of physical activity have health benefits, guidelines say
Even small bursts of physical activity have health benefits, guidelines say
(Pixabay)
Even two minutes of any physical activity -- taking the stairs, walking the dog or carrying out the trash -- can add up to significant health benefits, such as improved blood pressure, enhanced brain function and reduced risk of cancer and weight gain, according to the updated physical activity guidelines published in the Journal of the American Medical Association. The guidelines also recommend at least three hours of physical activity daily for children up to age 5 and at least 60 minutes of moderate to vigorous activity for those ages 6 to 17, while pregnant and postpartum women should engage in at least 150 minutes of moderate-intensity exercise weekly.
HealthDay News (11/12) 
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Health Insurance and Accountable Care Provider Company News
Solutions Provider News
Must see CX/Digital health speakers
From health plans to some of the most innovative startups and market disruptors focused on delivering a better health care experience, the speakers at AHIP's Consumer Experience & Digital Health Forum will challenge you, inspire you, and fill you with ideas. Register today.
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AHIP News
Virtual care takes center stage at CX/Digital
It also takes the stage at AHIP's Consumer Experience & Digital Health Forum where AHIP and Teladoc Health will share results of a survey focused on virtual care. You'll learn why and where health insurance providers are growing their virtual care offerings, what's expected from their investments, and how they are prioritizing virtual care in the near term. Register today.
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Save 30% on every job you post
The AHIP Career Center is a better environment for your job posts. It's precisely targeted to reach health care professionals. So you'll reach health care's best and brightest faster. And right now, save 30% on every job you post. Sale ends Dec. 31. Use coupon code HATS30. Post your jobs today!
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Georg Cantor,
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