Industry Roundup: A Medicare Advantage Pay Bump; Hospitals’ Partnerships With Local Agencies; Social Safety Nets And Health
CMS has finalized a bump for Medicare Advantage plans that's a good deal higher than the agency's initial proposal that met with fierce industry opposition. Meanwhile, researchers look at a variety of factors when it comes to spending and safety nets.
Modern Healthcare:
Medicare Advantage Plans Will Get A 1.66% Pay Bump For 2021
The CMS Monday finalized a 1.66% pay bump for Medicare Advantage plans, lower than last year's 2.53% pay raise. The agency is also finalizing several changes to how it pays Medicare Advantage and Part D plans, as well as Programs of All-Inclusive Care for the Elderly, or PACE. In February, the CMS proposed a 0.93% increase in payments for Medicare Advantage plans that met stiff industry opposition. (Brady, 4/6)
Modern Healthcare:
Hospitals Benefit From Partnering With Local Agencies For Older Adults
When mental health providers and hospitals partner with local agencies focused on helping older adults stay independent, Medicare spending decreases and nursing home use falls, according to a new study in Health Affairs. The study is the first of its kind to evaluate the impact of provider partnerships with Area Agencies on Aging, which are longstanding publicly or privately operated centers located in counties across the country that offer services to help older adults remain independent such as providing meals, in-home support and transportation. The agencies are partially funded by the federal government. (Castellucci, 4/6)
Modern Healthcare:
Social Safety Net Integral To Good Health, Researchers Find
Priority placement in affordable housing coupled with case management, financial and legal services for families that combat chronic diseases and housing instability significantly improved both physical and mental health compared with families that received the standard resource guides and hospital-based social work. The holistic model reduced the share of children with fair or poor health by 32 percentage points over six months and average scores for anxiety and depression among adult family members declined by 1.38 and 1.04 points, respectively, according to a new study from a group of Boston researchers published in Health Affairs. (Kacik, 4/6)
Modern Healthcare:
Social Workers Lower Patient Healthcare Use, Study Shows
Increasing patient access to social workers within primary care could lower hospitalizations and emergency department visits for higher-risk patients, according to a new study. Researchers found hiring social workers to work in underrepresented areas increased patient social work encounters by 33% over the study period. Those encounters were associated with a 4.4% decrease in hospitalizations among 43,000 high-risk patients, and a 3% reduction in emergency department visits. The findings were published Monday in Health Affairs. (Johnson, 4/6)
And in other news from the health industry —
Modern Healthcare:
Employer Group Purchasing Of Healthcare Attracting Interest
Jennifer Fairman, benefits manager of Larimer County, Colo., discovered last spring that her self-insured county’s health plan was paying UCHealth’s Poudre Valley Hospital more than 400% of Medicare rates for inpatient and outpatient services. A RAND Corp. study of hospital prices across the country also showed the county was paying Banner Fort Collins Medical Center, the other hospital in Fort Collins, 330% of Medicare rates. But most county employees were using the pricier UCHealth facility because they assumed the quality of care was better. (Meyer, 4/4)
The Washington Post:
Court Orders Maryland Company To Restore $28 Million To Employee Benefit Plans
A federal judge in Maryland has ordered a Bethesda-based company to restore more than $28 million to health benefit plans it sold to more than 100 employers. Brendan Turner and Susanne Sheil, former executives of the now defunct WH Administrators, failed to pay millions in medical expenses for plan participants and denied legitimate claims from plan holders, according to the court order. (Marimow, 4/6)
