Ashish Kachru, CEO at DataLink Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to […]
Homebound seniors contribute to higher overall Medicare spending compared to their non-homebound counterparts, according to a recent study from researchers at the Icahn School of […]
Healthpilot uses an AI-driven platform to help consumers determine what Medicare plan is best for them. On the startup’s website, users can input their location, […]
America is determining the shape of health care affordability into the future.
Larry Levitt writes about the political and practical impact of the health care provisions in the Inflation Reduction Act in The New York Times op-ed, “The Biggest […]
The giant health care, climate, and tax bill expected to pass the House on Friday and be sent to the president for his signature won’t […]
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This slideshow explains the prescription drug provisions proposed in the Inflation Reduction Act as passed by the Senate
What You Should Know: – Ellipsis Health and Ceras Health today announced a partnership that will integrate Ellipsis Health’s breakthrough technology that uses the human […]
The innovative Global Malnutrition Composite Score, approved by Centers for Medicare & Medicaid Services (CMS), will empower providers to deliver higher-quality care to patients. Hospital […]
Senate Democrats’ reconciliation bill “will strip $300 billion from Medicare.” Ad from the American Prosperity Alliance, posted July 19 As Senate Democrats raced to pass […]
Starting in 2025, Medicare recipients with prescription drug coverage will not have to pay more than $2,000 annually for medications, a significant savings for some.
Climate has received most of the attention. But the Senate bill brings big changes to health care, too.
A pulled pork BBQ sandwich stuffed with Reese’s Peanut Butter Cups, Fluffer Nutter sweet potato fries and deep-fried pickles smothered in gravy are all dishes you can […]
FAIR Health Monthly Telehealth Regional Tracker, May 2022, United States What You Should Know: – In May 2022, for the second straight month, telehealth utilization, as […]
The Senate passed Democrats’ Inflation Reduction Act on a party-line vote Sunday afternoon, delivering the long-awaited centerpiece to President Biden’s agenda. Democrats rallied behind the […]
The House is expected to take up the Senate-passed Inflation Reduction Act later this week, a sweeping bill that includes several landmark health care provisions […]
The vote was a major victory for President Biden and Democrats, who are battling to maintain their slim House and Senate majorities in November’s midterm […]
The legislation was a major victory for President Biden and Democrats, but a shadow of the transformative, multitrillion-dollar plan they proposed last year.
Democrats united behind the plan and advanced it over unanimous Republican opposition, signaling that they had finally coalesced behind a bill that could become law […]
Empowering Medicare to negotiate prices directly with drug makers has been a Democratic goal for 30 years, one the pharmaceutical industry has fought ferociously.
Empowering Medicare to negotiate prices directly with drug makers has been a Democratic goal for 30 years, one the pharmaceutical industry has fought ferociously.
What You Should Know: – The index of Healthcare & Life Science equities tracked by Stout was down 16.8% in Q2 2022, which was in […]
The Inflation Reduction Act of 2022, a sweeping measure that now looks likely to be passed through budget reconciliation by Senate Democrats in the US, […]
The narratives being built around the Senate’s latest price setting proposal frame it as a bill intended to lower drug prices for patients and address […]
About 95% of Medicare beneficiaries are anxious about inflation’s impact on healthcare costs, with 45% saying costs have already increased because of inflation, the eHealth […]
What You Should Know: – Homeward raises $50M Series B funding round co-led by ARCH Venture Partners and Human Capital. – The funding round also […]
Sen. Ron Johnson (R-Wis.) said Wednesday that Social Security and Medicare should be up for congressional approval each year, instead of staying under their current […]
A provision that limits the price of prescription drugs included in Democrats’ climate, health care and tax deal is the most popular piece of the […]
Last week, we examined ways the latest drug pricing proposal will undermine patient access to medicines, American medical innovation and our health care system as […]
In case you missed it, Saturday, July 30, marked the anniversary of Medicare. For 57 years, Medicare has helped pay for medical care for Americans […]
– Brave Health, a virtual-first behavioral health provider focused on serving Medicaid and Medicare populations, today announced an innovative referral partnership with MedArrive. – Through […]
A package of tax increases, lower drug prices and other provisions aimed at reducing the federal budget deficit could alleviate rapid price gains.
A package of tax increases, lower drug prices and other provisions aimed at reducing the federal budget deficit could alleviate rapid price gains.
A package of tax increases, lower drug prices and other provisions aimed at reducing the federal budget deficit could alleviate rapid price gains.
Members of Congress continue to push a misguided drug pricing proposal under the guise of negotiation as part of the reconciliation package. This proposal is […]
Sen. Joe Manchin and AARP “support government price-setting schemes” to divert money from Medicare to “unrelated government programs or pad big insurers’ profits.” Ad by […]
Sanjula Jain, PhD., Chief Research Officer, Trilliant Health Driven by headlines and incomplete, misleading data that favor a telehealth narrative, health systems and healthcare investors […]
Elizabeth Hogan Hamacher, MHL, BSN, RN, VP of Clinical Services and Support, Podimetrics Diabetes is one of the most common chronic diseases in the United […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you […]
On Tuesday, the U.S. Centers for Medicare & Medicaid Services (CMS) took the time to map out the federal agency’s strategic plans and key initiatives […]
What You Should Know: – Today, Innovaccer Inc., the Health Cloud company, announced that Curana Health is partnering with Innovaccer to build a leading edge […]
Discussions about spending in Medicare Part B, including a recent report from the Medicare Payment Advisory Commission, or MedPAC, too often overlook how competition between […]
The Oncology Care Model (OCM) is dead. The Oncology Care Model was a voluntary, alternative payment model (APM), that “included financial and performance accountability for […]
What You Should Know: – Canvas Medical, the EMR that enables clinicians and developers to power the future of care delivery, has raised $24M in […]
Only two provisions in a once-sprawling social spending package have survived; they would lower prescription drug prices in Medicare and insurance premiums for millions of […]
Only two provisions in a once-sprawling social spending package have survived; they would lower prescription drug prices in Medicare and insurance premiums for millions of […]
Home-based care services are a crucial element of medical care. Despite this fact, issues surrounding accessibility have hindered the Medicare home health benefit’s ability to […]
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Here I am, yet again, writing about the U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed rule for the home health care industry. But […]
In West Texas, the tiny hospital in Crosbyton has only two beds, and they’re not always occupied. “We rarely admit patients,” said Steve Beck, chief […]
What You Should Know: – Today Geisinger Health Plan (GHP) and Cohere Health, a provider of utilization management (UM) technology, announced they are joining forces to streamline the prior authorization process for […]
Siddharth Thakkar, VP, Product and Marketing at IKS Health For the better part of a decade, the shift toward value-based care in the U.S. has […]
As policymakers race to pass government price setting policies, it’s important to examine true public sentiment around such proposals. Voters have made clear that they […]
Dennis Wright, Sr. Director of Product Marketing at Omnicell Winston Churchill had great insight when he said, “Never let a good crisis go to waste.” […]
Democratic senators on Wednesday took a formal step toward reviving President Joe Biden’s economic agenda, starting with a measure to let Medicare negotiate prices with […]
Doug Duskin, CEO, Avel eCare COVID has shown us that telemedicine is effective and easy to use. But why limit the use of virtual care to public […]
An ounce of prevention … well, you know the rest. In medicine, prevention aims to spot problems before they worsen, affecting both a patient’s health […]
Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars […]
Rachael Jones, SVP of Performance Analytics and Quality at Cotiviti In Florida, where Black residents are three times more likely to be hospitalized or die […]
This year’s Alzheimer’s and Brain Awareness Month offers an important opportunity to remember the severe toll that Alzheimer’s takes on patients and family caregivers. Unfortunately, […]
Mike Ipekdjian, MBA-HM, BSN, RN, SANE, PHRN, NREMT, Head of Clinical & Solution Hospitals are increasingly turning to value-based care initiatives to transform care delivery, […]
Dr. Melissa Lim, Chief Medical Officer at Somnology Getting a good night’s sleep should have nothing to do with having a great health plan — […]
CVS Health intentionally prevented certain Medicare beneficiaries from accessing less expensive, generic prescriptions, according to […]
In discussions of Medicare’s financial condition, attention frequently centers on one specific measure—the solvency of the Medicare Hospital Insurance (HI) trust fund, out of which […]
Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York […]
The Medicare Payment Advisory Commission (MedPAC) is, once again, calling for federal policymakers to streamline alternative payment models within the Medicare program. Released late Wednesday, […]
At least two-thirds of older Americans see healthcare costs as a financial burden, according to a new West Health-Gallup survey published Wednesday. About 24 percent […]
Mary Butler-Everson, SVP of Healthcare Product Innovations for PNC Treasury Management Achieving fluid data interoperability has been a complex and challenging goal for the U.S. […]
MEXICO, Mo. — When the new corporate owners of two rural hospitals suddenly announced they would stop admitting patients one Friday in March, Kayla Schudel, […]
Michael Gardner, Chief Strategy Officer at Virsys12 As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a […]
The Biden administration is considering a requirement that the nation’s 15,500 nursing homes spend most of their payments from Medicaid on direct care for residents […]
Shawna Koch Mishael, Head of Healthcare and Biomedical, RN, MBA, SenecaGlobal This year’s HIMSS Conference offered some exciting insights and a renewed focus on data-sharing […]
These FAQs review mental health and substance use disorder coverage and out-of-pocket costs in Medicare and discuss policy proposals related to coverage of mental health […]
In September, AARP, the giant organization for older Americans, agreed to promote a burgeoning chain of medical clinics called Oak Street Health, which has opened […]
Medicare funds – which are the largest payer of home health care services – are not running out quite as fast as previously predicted. After […]
Progressives are criticizing the Biden administration’s recent announcement that the 2022 Medicare premium will not be cut despite lower-than-expected costs for a new Alzheimer’s medicine. […]
Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds came out with their annual report on the state […]
What You Should Know: – Homeward, the comprehensive rural care provider network launched by former Livongo titan, Dr. Jenny Schneider, has announced a partnership with […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you […]
What You Should Know: – CareMax, a tech-enabled provider of value-based care to seniors announced an agreement to acquire the Medicare value-based care business of […]
Robin Bolduc isn’t the type of person who takes “no” for an answer — particularly when it comes to fixing her husband’s wheelchair. Her husband, […]
Total spending among traditional Medicare beneficiaries fell in 2020, the first year of the COVID-19 pandemic, corresponding to lower service use across most types of […]
Medicare spending for skilled nursing facilities increased in 2020 despite an overall decrease in the number of Medicare beneficiaries using SNF services. The higher spending […]
Karen Conway, VP of Healthcare Value, Global Healthcare Exchange (GHX) All the signs point to a bright and expansive future for hospital-at-home programs, which have […]
The traditional brick-and-mortar hospital system is broken, often leaving patients in a condition that’s worse than when they first arrived. That’s according to a May […]
Health and Human Services Secretary Xavier Becerra announced on Friday that Medicare premiums would be adjusted for 2023 following a report that found the cost […]
Dr. Martin Sellberg, Co-Founder of Motient Nurses and providers typically assess patient acuity and volume at the beginning of their shift, whether formally or informally. […]
What You Should Know: – Homethrive, a tech-enabled healthcare service company that’s disrupting and revolutionizing how employers, insurers, and affinity groups support unpaid family caregivers […]
Home health care providers and Medicare-for-all advocates certainly agree on their general disliking of Medicare Advantage (MA). The one problem is that these advocates are […]
U.S. prescription drug spending per person is about double what it is in peer countries and about 8 in 10 U.S. adults say the cost […]
These FAQs provide answers to questions about Medicare’s current coverage of telehealth, changes made at the outset of the public health emergency, additional changes adopted […]
Low-income Americans on Medicare can get assistance paying their premiums and other expenses. Several states have allowed more people to qualify.
What You Should Know: – Olive, the automation company creating the Internet of Healthcare, today announced its partnership with Magenta Care Continuum, a HIPAA-compliant health records […]
What You Should Know: – Today, Polygon Networks, a leading blockchain and scaling solution, announced a partnership with Tokenology and MSP Recovery to deliver LifeChain […]
This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal […]
U.S. hospitals have been stuck with more than $702 billion in uncompensated care costs for the past 2 decades, and the number continues to grow. […]
Addressing the cost of insulin continues to be at the forefront of policy discussions around prescription drugs. This analysis describes out-of-pocket spending on insulin products […]
Accountable care organizations (ACOs) have considerably increased their home-based care arsenals over recent years. They’ve also diversified the types of home-based care they offer, and […]
Despite occasional anecdotal reports of people having trouble finding a doctor who takes their insurance, KFF researchers find in a new analysis that the vast […]
This brief examines the share of non-pediatric office-based physicians accepting new patients with Medicare or private insurance and how these rates have changed over time […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
The Centers for Medicare & Medicaid Services (CMS) recently released their National Health Expenditure (NHE) projections of health care spending in the United States through 2030. […]
What You Should Know: – Three leading organizations that provide healthcare services to senior living communities – Elite Patient Care, Provider Health Services, and AllyAlign Health […]
Anne Davis, VP of Government Markets & Strategy at Wellth Structural racism and poverty are correlated with a higher incidence of obesity among Black Americans […]
The drug company will effectively give up on marketing Aduhelm, which comes with unproven benefits and serious safety risks.
The drug company will effectively give up on marketing Aduhelm, which comes with unproven benefits and serious safety risks.
The drug company will effectively give up on marketing Aduhelm, which comes with unproven benefits and serious safety risks.
The drug company will effectively give up on marketing Aduhelm, which comes with unproven benefits and serious safety risks.
The drug company will effectively give up on marketing Aduhelm, which comes with unproven benefit and serious safety risks.
Something strange happened between the time Linda Griffith signed up for a new Medicare prescription drug plan during last fall’s enrollment period and when she […]
In the past, seniors in Medicare had to pay for all their prescription drugs out-of-pocket. For elderly individuals with multiple medical conditions, this lack of […]
Despite the growing demand for home health services, fraud and abuse guardrails often limit access to the Medicare benefit, a recent Bipartisan Policy Center (BPC) […]
Medicare Advantage Organizations (MAOs) delayed or denied payments and services to patients, even when these requests met Medicare coverage rules, according to a report released […]
In yesterday’s post, we learned how Medicare Part D works for seniors and people with disabilities. Unfortunately, Part D beneficiaries are increasingly facing higher out-of-pocket […]
Medicare Part D provides prescription drug coverage for our nation’s seniors and Americans with disabilities. These beneficiaries can opt to enroll in Part D and […]
A new KFF interactive provides essential facts and trends about spending on Medicare, the federal health insurance program that covers 65 million seniors and people […]
Medicare Part D plans have begun using preferred pharmacy networks in order to steer their beneficiaries to lower cost pharmacies. A key question is, does […]
What You Should Know: – Blue Cross Blue Shield of Michigan (BCBSM) today announced a joint venture with Nashville-based Honest Medical Group to offer physicians comprehensive operational, clinical, […]
Compared to fee-for-service Medicare, seniors save close to $2,000 on average in total annual health care spending with Medicare Advantage (MA). That’s according to a […]
With more eyes than ever on home-based care, there are a number of legislative and regulatory developments that will be critical for providers to stay […]
Ben Tengelson, VP of Data Science at IntelyCare To make it easier for families and caregivers to evaluate the quality of nursing homes, the Center […]
What You Should Know: – Centers for Medicare & Medicaid Services’ (CMS) payment adjustments did not adequately address hospitals increased costs for FY 2021, according […]
Home health operators should dig in even further ahead of the Medicare reimbursement battle coming later this year. The U.S. Centers for Medicare & Medicaid […]
Tom Zaubler, MD, Chief Medical Officer of NeuroFlow Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. healthcare […]
Medicare beneficiaries with low incomes and modest assets can qualify for additional financial help with Medicare premiums and cost sharing through both the Medicare Savings […]
This data note provides an overview of programs that help beneficiaries with most incomes with their Medicare costs, including the Medicare Savings Programs (which provide […]
These state profiles capture the variations across states in the number and characteristics of Medicare beneficiaries through the Medicare Savings Programs and Medicare’s Part D […]
The program, called Digital Bridge, will leverage Icario’s expertise in personalized health communications to help plans ensure members are able to access resources available to […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Shahyan Currimbhoy, VP at Edifecs Aaron Fulner, Sr. Director at Edifecs Up until now, risk adjustment has been addressed as a mechanism to accurately represent the overall risk profile of […]
The Series B funding round was led by Enhanced Healthcare Partners. Hoboken, New Jersey-based Vytalize has grown its patient base 150% year-over-year and is now […]
What You Should Know: – Vytalize Health raises over $50 million to advance its value-based care platform for seniors helping primary care doctors strengthen relationships […]
The US Centres for Medicare and Medicaid Services (CMS) has firmed up its draft decision to limit reimbursement of Biogen’s Alzheimer’s disease therapy Aduhelm to […]
Officials cited data showing the new Alzheimer’s drug has serious safety risks and may not help patients.
En Whitman-Walker Health, el doctor David Fessler y su personal administran dosis altas de vacunas contra la influenza a todos los pacientes VIH positivos y […]
At Whitman-Walker Health, Dr. David Fessler and his staff administer high-dose influenza vaccine to all HIV-positive and senior patients. Although the vaccine is roughly three […]
The Alzheimer’s Association has pushed relentlessly to get broad access to Aduhelm, despite safety risks and uncertain evidence that it helps patients.
People on Medicare are now able to get up to eight free COVID-19 tests per month at participating pharmacies, the Biden administration announced Monday. The […]
What You Should Know: – Blessing Health System, an integrated rural health system selects Biofourmis, a virtual care and digital therapeutics provider to launch its own […]
When Reyna or Justin Ansley or one of their three kids feels sick and needs to be tested for strep throat or flu, there’s a […]
What specialty providers and seniors need is a sustainable solution to preserve the federal health insurance program and properly reimburse providers.
CELINA, Tenn. — It was about 1 a.m. on April 19, 2016, when a burglary alarm sounded at Dale Hollow Pharmacy in Celina, a tiny […]
U.S. health care expenditures ballooned in 2020 because of the COVID-19 pandemic, but they’re starting to normalize. National home health spending, in turn, experienced a […]
Mike Serbinis, Co-Founder and CEO of League The COVID-19 pandemic feels like a once-in-a-lifetime event for those of us involved in healthcare, but the patterns […]
Home health agencies have had to navigate several changes since 2020, from the payment mechanics of the Patient-Driven Groupings Model (PDGM) to the new policies […]
Medicare’s Comprehensive Kidney Care Contracting model spotlights the importance of proactive, coordinated kidney care. It’s critical for nephrology practices to start incorporating this patient-centric approach […]
Dr. Toyin Ajayi, CEO at Cityblock Health What You Should Know: – Cityblock Health, a value-based healthcare provider for Medicaid, dually-eligible and lower-income Medicare beneficiaries […]
What You Should Know: – Recora today emerged from stealth to announce $20M in Series A funding led by SignalFire with participation from Valor Equity Partners and […]
Home health agencies and other Medicare-reimbursed health care providers are just a couple weeks away from the return of sequestration. For many agencies, the restart […]
What You Should Know: – The 32BJ Health Fund, a self-insured fund that provides care for 32BJ SEIU members and their dependents, today released a report that […]
Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question […]
Since its inception in 2006, Medicare Part D beneficiaries had to contend with the dreaded “doughnut hole”. The “doughnut hole” is a coverage gap during […]
In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several […]
Widowed and usually living alone, Gloria Bailey walks with a cane after two knee replacement surgeries and needs help with housekeeping. So she was thrilled […]
Last spring, Lags Medical Centers, a sprawling chain of pain clinics serving more than 20,000 patients in California, abruptly shuttered amid a cloaked state investigation […]
This analysis looks at in-network payment rates for inpatient hospital stays, other than maternity/newborn admissions, among large employer plans relative to Medicare payment rates. We […]
What You Should Know – Homeward, a new company focused on improving access to high-quality, affordable primary and specialty care in rural communities launches with an initial […]
What You Should Know: – Aetion, real-world evidence (RWE) tech and analytics provider, and Cognito Therapeutics, a pioneer in neuromodulation therapeutics for neurodegenerative diseases like Alzheimer’s, are partnering […]
Heather Korbulic, Senior Policy and Strategy Lead, GetInsured The COVID-19 pandemic led to sweeping healthcare policy changes that enable vulnerable Americans to receive affordable health coverage and access […]
According to a paper by Rodriguez et al. (2022), the answer is ‘yes’. They use data from the 2017–18 National Survey of Healthcare Organizations and […]
If you listen to the nation’s largest Alzheimer’s disease advocacy organizations, you might think everyone living with Alzheimer’s wants unfettered access to Aduhelm, a controversial […]
What You Should Know: – Lynx, a Boston-based API-connected healthcare payments, banking, and e-commerce platform announced today that it has emerged from stealth with $17.5M in […]
President Joe Biden’s top Medicare official suggested Wednesday that forthcoming rules to bolster nursing home staffing won’t be issued under a4 mechanism, known as interim […]
As a parting gesture to a pandemic-ravaged city, former New York Mayor Bill de Blasio hoped to provide the city with a gift that would […]
BY NIRBAN SINGH AND AMY HELBURN Introduction Medicare Advantage (Advantage), originally conceived in 1997 during the Clinton Administration as ‘Medicare + Choice’, has progressively grown […]
President Joe Biden argued forcefully for the power of democracy while calling out Russia’s invasion of Ukraine in a March 1 State of the Union […]
Brett Furst, President, HHS Technology Group You don’t have to be a news junkie or political aficionado to know that state unemployment information systems massively […]
What You Should Know: – Butterfly Network today launched Butterfly Blueprint, a system-wide platform that supports scaled deployment of ultrasound across hospitals and health systems. – Blueprint integrates ultrasound information into health […]
What You Should Know: – XRHealth, the gateway to the healthcare metaverse, announced today that they raised $10M in funding to expand virtual healthcare treatment in the Metaverse. The […]
Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance […]
A congressional effort to fix the nation’s deteriorating mail service may come at the expense of an even bigger and more complicated problem: Medicare solvency. […]
What You Should Know: – Story Health, a health technology and services company that extends specialty care into patient’s homes raises $22.6M in Series A […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. Therapists […]
HANFORD, Calif. — On May 13 of last year, the cellphones of thousands of California residents undergoing treatment for chronic pain lit up with a […]
Samantha Young, a political correspondent for California Healthline, on Feb. 15 discussed how Medi-Cal patients struggle to get their prescription drugs on KCRW’s “Press Play.” […]
Medicare Part B covers a wide range of health care services, including physician office visits, hospital outpatient care and medical equipment. It also covers medicines […]
What You Should Know: – NourishedRx, a digital health company raises $6M in seed funding led by S2G Ventures with additional investors Route 66 Ventures, […]
The drug industry, patient advocates, and congressional Republicans have all attacked federal officials’ decision to decline routine Medicare coverage for a controversial Alzheimer’s drug. They’ve […]
Suzanne Cogan, General Manager, SPH Analytics, a Press Ganey Solution Healthcare organizations are increasingly eager to leverage analytics technologies, including machine learning and artificial intelligence […]
Coverage for lung cancer screening has been expanding in the private market, even before a […]
In comments submitted this week, PhRMA urged the Centers for Medicare & Medicaid Services (CMS) to withdraw its proposed national coverage determination (NCD) for monoclonal […]
Japanese drugmaker Eisai has published comments filed with the US Centers for Medicare & Medicaid Services over its restrictive coverage proposal for beleaguered Alzheimer’s drug […]
The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for […]
Eli Lilly has backed away from plans to file Alzheimer’s drug donanemab in the first quarter of this year, saying the proposal to limit reimbursement […]
The drug pricing provisions in the Build Back Better Act (BBBA) would allow the government to set the price of certain medicines in Medicare. This […]
The government’s flawed price setting plan under the Build Back Better Act will significantly upend the biopharmaceutical research and development (R&D) process, risking important advances […]
The Biden Administration’s requirement for private insurers to cover the cost of at-home rapid COVID-19 tests for their enrollees does not apply to Medicare. Medicare […]
A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal […]
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. The […]
As we kick off 2022, Congress has a number of priorities they are aiming to tackle, including the Build Back Better Act (BBBA). Unfortunately, the […]
It turns out that the laws governing traditional Medicare don’t provide for coverage of self-administered diagnostic tests. Medicare patients are left to seek free tests […]
For home health providers, the transition to the no-pay Request for Anticipated Payment (RAP) was a period of adjustment. Now, the Notice of Admission (NOA) […]
What You Should Know: – RecoveryOne, a digital health innovator dedicated to improving health outcomes for recovery from musculoskeletal (MSK) injuries of all types and reducing costs, announced […]
What group is especially vulnerable to the ravages of covid-19 even if fully vaccinated and boosted? Seniors. And who will have an especially tough time […]
The U.S. Supreme Court on Thursday threw its support behind the nationwide COVID-19 vaccine mandate for health care workers, while simultaneously axing a vaccine-or-test rule […]
By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for […]
Financial planning for people with chronic diseases is complicated and multifaceted. Start by building a team of people to help.
In a new Policy Watch, KFF experts explain why Medicare’s preliminary decision to cover a new Alzheimer’s drug only for a limited group of beneficiaries […]
This policy watch discusses the implications of Medicare’s preliminary National Coverage Determination for the new Alzheimer’s drug, Aduhelm, on the 2022 Medicare Part B premium […]
Financial planning for people with chronic diseases is complicated and multifaceted. Start by building a team of people to help.
Financial planning for people with chronic diseases is complicated and multifaceted. Start by building a team of people to help.
The Supreme Court on Thursday blocked a key Biden administration covid-19 initiative — putting a stop, for now, to a rule requiring businesses with more […]
The long-awaited decisions regarding the Biden administration’s vaccine mandates have finally arrived from the U.S. Supreme Court. In the end, the Occupational Safety and Health […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Biogen’s difficult launch of controversial Alzheimer’s therapy Aduhelm has been made even harder by a proposal by Medicare to cover the drug only for certain […]
If the preliminary decision is finalized this spring, it would restrict coverage to patients in randomized clinical trials.
If the preliminary decision is finalized this spring, it would restrict coverage to patients in randomized clinical trials.
If the preliminary decision is finalized this spring, it would sharply limit the number of patients who use the expensive drug.
By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for […]
Medicare officials are trying to determine whether to cover Aduhelm, which the F.D.A. approved despite unclear evidence that it helps patients.
The U.S. Centers for Medicare & Medicaid Services (CMS) released guidance on evaluating providers’ compliance with the federal COVID-19 vaccination mandate for health care workers. […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
A higher Medicare premium in 2022 is just part of the puzzle of health care costs for older Americans. But there are ways to plan.
A higher Medicare premium in 2022 is just part of the puzzle of health care costs for older Americans. But there are ways to plan.
A higher Medicare premium in 2022 is just part of the puzzle of health care costs for older Americans. But there are ways to plan.
A higher Medicare premium in 2022 is just part of the puzzle of health care costs for older Americans. But there are ways to plan.
A higher Medicare premium in 2022 is just part of the puzzle of health care costs for older Americans. But there are ways to plan.
What You Should Know: – Medicare Advantage provider Zing Health raises $25M from Town Hall Ventures and Leavitt Equity Partners, two leading investors focused on growing […]
Biogen has cut the list price of its Alzheimer’s disease therapy in half from $56,000 to $28,200 a year, before the outcome of an ongoing […]
While some in Congress continue to claim the latest drug pricing plan in Washington is “negotiation,” that is far from the truth. The reality is […]
Medicare-certified home health providers are falling short when it comes to the amount of care services they’re offering, a new survey released Thursday from the […]
What You Should Know: – Ilumed, a Medicare transformation company focused on assisting patients to achieve their healthiest lives by driving lower cost, better quality […]
A new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) estimates that health care spending in the […]
This issue brief examines the new regulations, explains the status of the pending litigation, and identifies issues to watch.
The measurements used to track the home health industry could use some updating to better align perception with reality, according to the Medicare Payment Advisory […]
The Senate on Thursday voted 59-35 to pass a bill delaying statutory cuts to the Medicare program. The House passed its own version of the […]
Sharon Marchio misses having teeth for eating, speaking and smiling. For the past few years, after the last of her teeth were extracted, she’s used […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Some policymakers in DC are laser focused on giving the government the power to “negotiate” in Medicare. What they aren’t saying is that this isn’t […]
Home health stakeholders that have been on pins and needles about the return of possible Medicare cuts saw the first step toward securing further delay […]
Common-sense reforms can help ensure everyone benefits from America’s engine of innovation and receives the care they need and deserve. In this series, we’re taking […]
This slideshow explains the latest prescription drug provisions in the Build Back Better Act (BBBA).
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. On […]
Maybe this has happened to you recently: Your doctor telephoned to check in with you, chatting for 11 to 20 minutes, perhaps answering a question […]
“An independent analysis shows that payments for cancer care will be slashed by close to 45% causing cancer clinics to close and massively raising your […]
President Biden emphasized how the bill would lower prescription drug costs, an issue his administration hopes will build support for the broader package.
President Biden emphasized how the bill would lower prescription drug costs, an issue his administration hopes will build support for the broader package.
A study by the U.S. Department of Health and Human Services found that telehealth use increased 63-fold during the pandemic. But it also found significant […]
Despite tremendous progress and knowledge gained from post-approval R&D, some in Congress still fail to recognize innovation doesn’t stop at U.S. Food and Drug Administration […]
Both chambers of Congress passed legislation this week to keep the government funded through Feb. 18. Home health agencies and other Medicare stakeholders are worried, […]
Taken together, the provisions in the social policy bill represent the biggest step toward universal coverage since the passage of the Affordable Care Act.
Wednesday, December 8, 2021 at 9:00 a.m. PT/12:00 p.m. ET As the Build Back Better Act shifts from the House to the Senate, there’s considerable […]
Wednesday, December 8, 2021 at 9:00 a.m. PT/12:00 p.m. ET As the Build Back Better Act shifts from the House to the Senate, there’s considerable […]
Taken together, the provisions in the social policy bill represent the biggest step toward universal coverage since the passage of the Affordable Care Act.
Taken together, the provisions in the social policy bill represent the biggest step toward universal coverage since the passage of the Affordable Care Act.
First it was the COVID-19 vaccination mandate from the U.S. Occupational Safety and Health Administration (OSHA). Now, it’s the one from the Centers for Medicare […]
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