Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare To Cover Program Pioneered By YMCA To Prevent Diabetes
The Washington Post: Medicare To Begin Paying For Diabetes Prevention Strategy
Medicare will start paying for a strategy to help millions of older Americans at high risk of diabetes from developing the disease, federal health officials announced Wednesday. The new benefits, scheduled to begin in 2018, are part of an increasing shift in the federal entitlement program, from its half-century tradition of mainly covering treatment when beneficiaries are sick to paying to try to keep them healthy. The strategy to avert diabetes also is the first disease-prevention experiment, tested under part of the Affordable Care Act, which federal officials have concluded is worthwhile enough to adopt nationwide. (Goldstein, 11/2)
USA Today: Feds Approve Y's Diabetes Program Despite Drug Maker Opposition
Federal regulators will move ahead with a national test of Medicare coverage for a YMCA diabetes prevention program over the objections of the pharmaceutical industry, which sells drugs including increasingly expensive insulin to treat disease. The final rule, announced Wednesday by the Centers for Medicare and Medicaid Services, is designed to speed Medicare coverage of a program to combat a disease that a quarter of people 65 and older have. National trade associations representing hospitals and doctors enthusiastically supported CMS' plan in comments filed with the agency. (O'Donnell, 11/2)
Modern Healthcare: CMS Funnels $140 Million More Into Medicare Primary-Care Payments
The CMS Wednesday announced changes to how Medicare pays for primary care that could result in an estimated $140 million in additional funding in 2017 to providers. The agency says several coding and payment changes could eventually lead to as much as $4 billion or more being funneled into care coordination and patient-centered care. Historically, care management related activities have been “bundled” into the evaluation and management visit codes used by all specialties. That meant payment was distributed equally among all specialties that report the visit codes, instead of being targeted toward practitioners who manage care and/or primarily provide cognitive services.“ (Dickson, 11/2)
