Medicare Advantage Enrollment Continues To Climb Despite Insurers’ Complaints
Consumers flock to the programs because of the broad benefit packages and affordable premiums, reports Modern Healthcare. Meanwhile, Pennsylvania officials threaten action to protect Medicare Advantage enrollees caught in a spat between UPMC and Highmark and a draft rule would give Medicare providers greater flexibility to show they are using digital records.
Modern Healthcare:
Despite Rate Complaints, Advantage Plans Continue To Grow
Medicare Advantage insurers received welcome news last week when the CMS said it will boost payment rates for 2016 by the highest amount since the Affordable Care Act was enacted. Insurers have complained bitterly about the yearly rate uncertainty, but Advantage enrollment has grown by about 8% annually since 2010. What gives? (Herman, 4/11)
Modern Healthcare:
Pa. Threatens Lawsuits Over UPMC Plan To Spike Highmark Medicare Advantage Contract
Healthcare giant UPMC's plans to terminate its Medicare Advantage contracts with insurer Highmark, which also owns a rival health system, has drawn threats of legal action from Pennsylvania state leaders. (Schencker, 4/10)
Modern Healthcare:
CMS Draft Rule Would Ease EHR Program Demands
The CMS intends to give more flexibility to hospitals, office-based physicians and other healthcare providers to meet federal targets for the meaningful use of electronic health records, according to a proposed rule the agency issued late Friday. Chief among the changes in the 210-page draft rule is a proposal to standardize the 2015 reporting period for the EHR incentive-payment program to 90 consecutive days of achieving meaningful-use criteria. (Conn, 4/10)
The Washington Post highlights Medicare cost-saving ideas from various reports -
The Washington Post:
Six Examples Of Government Waste From This Year’s Budget-Hawk Reports
Citizens Against Government Waste released its annual “Prime Cuts” report this month, recommending programs that the government could eliminate for some $648 billion in savings next year. ... Not all the “Prime Cuts” recommendations come in the form of cuts. Some call for ramping up efforts to prevent fraud and improper payments. The report recommends reinstating the Recovery Audit Contractor program, which helped recover nearly $10 billion in improper Medicare payments over eight years. The Centers for Medicare and Medicaid Services halted the initiative last year amid a backlog of more than 350,000 appeals. (Hicks, 4/13)
And NPR looks at why some doctors worry that annual lung cancer screenings do more harm than good -
NPR:
Why Some Doctors Are Hesitant To Screen Smokers For Lung Cancer
In February, Medicare announced that it would pay for an annual lung cancer screening test for certain long-term smokers. Medicare recipients between the ages of 55 and 77 who have smoked the equivalent of a pack a day for 30 years are now eligible for the annual test, known as a spiral CT scan. Medicare's decision was partly a response to a 2011 study showing that screenings with the technique could reduce lung cancer deaths by 20 percent. ... But as more and more people are getting screened for lung cancer, other doctors worry the test is doing more harm than good. (Kelto, 4/13)
