Complaints about Medicare Advantage ads (and other CMS headlines)
Complaints about Medicare Advantage ads (and other CMS headlines)
Friday Pulse Check
Good morning and happy Friday. This week on the Friday Pulse Check, we’ve unintentionally taken a dive in to Centers for Medicare and Medicaid Services (CMS) headlines, however we expect that you’ll find them as interesting as we did.
Hospitals could earn Medicare incentives by electronically reporting health data
Becker’s Hosptial Review and Pew are reporting that a new Centers for Medicare and Medicaid Services (CMS) rule would boost hospitals’ Medicare reimbursement rates if they electronically report health data to state and federal agencies instead of by mail or fax. Under the rule, hospitals that submit electronic health records (EHRs) will avoid cuts to reimbursement. Advocates for the new rule, including Pew, say electronic access to patient data can help agencies better identify disease outbreaks and health inequity. It goes into effect on October 1st.
CMS toughens oversight on celebrity pitches
We’ve all seen Joe Namath, William Shatner, and Jimmie “J J” Walker promoting Medicare Advantage on TV, and apparently they are starting to make people annoyed. Last year, consumer complaints over celebrity-endorsed Medicare Advantage plans rose 165% compared to the number of 2020 complaints. CMS said that many of the complaints arise over confusion about who actually runs the Medicare Advantage plans. Senior advocates have also said that sometimes seniors are not told their longtime physician is not in-network for their new plan until they show up for an appointment. Read more in the Wall Street Journal.
Biden admin wants to overhaul CHIP and Medicaid enrollment
This week CMS proposed a new rule that streamlines applications and standardizes eligibility and enrollment policies for the Children’s Health Insurance Program (CHIP) and Medicaid nationwide. Included in the proposal is a way for states to transfer children from Medicaid to CHIP when their parents’ income increases. The proposed rule would also end lifetime benefit limits. The proposed rule is now in a sixty day commenting window and all comments must be submitted to the Federal Register by November 7th. Read the proposed rule here.
The rising cost of everything
What product or service right now doesn’t cost more than it did a year ago? Fortunately in the last few months, most Americans have seen the average cost of gas come down but prices remain high in many other areas of the US economy. Not excluded from this is the cost of labor and supplies for many hospitals and doctors’ offices.
This week on the FLATLINING Podcast, Ron and I discussed how the costs got so high and what hospitals and providers can do (and are doing) to shield themselves against bad economies in the future.
As we explain in the program, the price of gas can be adjusted immediately if supply is short and demand is high (or vice versa). The gas station operator can change the price on the sign and that’s that. Physicians, on the other hand, cannot adjust to inflation or price hikes quickly because they are largely locked into contracts with the insurance carriers or their prices are fixed by Medicare.
Check out this episode to hear more about how we got here and what can be done.
Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, and Audible.
Ukraine
The St. Jude Global initiative of St. Jude Children's Research Hospital and several other international partners have begun to work together to create Supporting Action for Emergency Response in Ukraine (SAFER Ukraine). The organization is trying to innovate the concept of global healthcare and create a new way for the international community to respond to health crises. One benefit that SAFER Ukraine seeks to provide is the ability to move patients quickly. If care was interrupted, as it has been in Ukraine, patients can be rapidly evacuated and relocated where their survival chances increase. Read more from Medical Xpress.
Final Thought
For the first time ever, smoking marijuana has become more popular than smoking tobacco. Data from a new Gallup poll shows 16% of American use cannabis while only 11% of Americans report being cigarette smokers. The amount of American cigarette smokers is the lowest since Gallup began asking in 1969. Another Gallup poll in July also showed that Americans are much less hostile to marijuana usage than they were before; 49% said it has a positive effect on society. Wherever you fall on the legalization question, there is no doubt about it: its usage is continuing to increase. Read more from Gallup.
Have a good long weekend,
Matthew