Medicare

Major Health Affairs Conference Discusses What's next for PPACA Implementation

A few weeks ago, many of the country’s leading health experts gathered in Washington D.C. at a Health Affairs sponsored conference entitled “What’s Next for the Affordable Care Act (PPACA) Implementation.”

Author: Michael Gomes

CMS Reports Trends in National Health Care Spending: Short-Term Health Care Inflation Rates Are In-Check But Long-Term Outlook Not As Clear

The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary recently released its updates to the document, National Health Spending Projections: The Estimated Impact of Reform Through 2019. The revised report appears in the December 2011 edition of Health Affairs (subscription only). The update includes health care cost and utilization data and the preliminary estimates of the impact of the Patient Protection and Affordable Care Act (PPACA).

The Good News

Author: Michael Gomes

Concierge Medicine: Changing the Future of Primary Care for Better or for Worse?

Visiting the doctor’s office may not top the list of favorite activities for most consumers, but eliminating common stressors such as juggling one’s schedule to squeeze in an appointment, spending too much time in the waiting room, and then maybe seeing the physician for only a few minutes, can make the experience much more pleasant. 

What if the majority of this stress could be alleviated? According to the American Academy of Private Physicians (AAPP), use of “concierge” or retainer-based physicians can be part of the solution. In fact, the number of these types of physician services has doubled in the past two years, according to AAPP. 

Author: Tiffany Stiller

Federal Government Taps 32 Organizations to be Pioneer ACOs

On December 19, 2011, the U.S. Department of Health and Human Services (HHS) announced that the federal agency has approved 32 organizations to become Pioneer Accountable Care Organizations. 

Through the Patient Protection and Affordable Care Act (PPACA), the federal government has promised to deliver improved health care while attempting to better control future costs. Among other initiatives, the new health care reform law authorizes the creation of Accountable Care Organizations (ACOs). 

Pioneer ACO Initiative

Author: Michael Gomes

Contract Award Puts Wheels in Motion for Establishing Federal Insurance Exchange Program

In an effort to provide consumers with competitive insurance options as mandated by the Patient Protection and Affordable Care Act (PPACA), the federal government has awarded a $93.7 million, multi-year contract to CGI Federal, Inc. to establish a federal health insurance exchange. The Centers for Medicaid & Medicaid Services (CMS) Center for Consumer  Information & Insurance Oversight (CCIIO) has hired CGI Federal, Inc., a U.S.  subsidiary of CGI Group, Inc., to build the federally-sponsored health insurance marketplace that will “provide millions of Americans with ‘one-stop shopping’ for affordable coverage,” according to the CCIIO website. The CGI Group, Inc.

Author: Bernard DiFiore

HHS Launches Demonstration Project to Improve Care for Medicare Beneficiaries through Federally Qualified Health Centers

The U.S. Department of Health and Human Services (HHS) recently announced a joint initiative between the Centers for Medicare and Medicaid Services (CMS) and the Health Resources Service Administration (HRSA) that allocates $42 million dollars to improve care for Medicare beneficiaries in 500 Federally Qualified Health Centers (FQHC) in 44 states across the country. This initiative is expected to help up to 195,000 beneficiaries.

Author: Michael Gomes

Medicare to Cover Preventive Services to Reduce Obesity: Prevention and Wellness Programs Gaining Momentum in Private and Public Sectors

Late last month, the Centers for Medicare and Medicaid Services (CMS) announced that the Medicare program will cover preventive services in an effort to combat obesity. In the past year, the federal government has launched a number of programs and funding initiatives to address the growing waistlines of Americans of all ages. The goal is to help us to live longer and healthier lives – along with reducing the cost associated with treating disease and managing chronic illness. Many of these campaigns have been fueled by the Patient Protection and Affordable Care Act (PPACA). These efforts mirror recent trends by health insurers and employers in the private sector to promote health and wellness.

Author: Michael Gomes

CMS Head Touts the Need for a Comprehensive Strategy to Support Medicare: Calls for Partnership with the Private Sector

In a keynote address delivered at the American Health Insurance Plan’s (AHIP) annual Medicare Conference on September 12, Donald M. Berwick, MD, administrator for the Centers for Medicare & Medicaid Services (CMS), addressed a number of issues associated with the long-term financial health of the Medicare Program.[1]

His 45-minute speech centered on the need to address the rising costs required to fund the federal program supporting American seniors and a few special populations. In a humorous moment, Dr. Berwick noted that he just celebrated a big birthday last week and is now eligible to become a Medicare beneficiary himself, which has added some urgency to the matter.    

Author: Michael Gomes

CMS Launches Quality Health Care Compare Tool for Consumers

As a follow-up to our previous blog on the Hospital Value-Based Purchasing Program, the Centers for Medicare and Medicaid Services (CMS) has launched a more expansive tool to help consumers compare quality for a number of different provider types. 

On August 5, CMS announced a new quality “compare” finder tool embedded in a web portal, so consumers can easily assess information about the quality of care and services of health care providers. The new portal is geared to Medicare beneficiaries, but can be used by anyone, and provides helpful information about providers by specialty or by different types of facilities.

Author: Michael Gomes

HHS Implementing Value-Based Purchasing Initiative for Hospitals

Last spring, the U.S. Department of Health and Human Services (HHS) announced a new initiative aimed at rewarding hospitals for quality of care, safety and affordability. Authorized by the Patient Protection and Accountable Care Act (PPACA), the Hospital Value-Based Purchasing Program marks a significant change in the way Medicare pays health care providers and facilities. The goal of the program, according to an HHS statement, is to pay hospitals for inpatient acute care services based on care quality, not just the quantity of services. Implementation of this program is taking place now through July 2014. 

Author: Michael Gomes
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