Category: Medicare Advantage (MA)

For Home Care Agencies, Tracking ‘Total Cost of Care’ Is the Secret to Breaking into Narrow Networks

Home care agencies and their services have always been valuable to the patients they serve. But being able to demonstrate that value to payers requires more than just patient testimonials. As the home care industry enters into an era filled with new tailwinds, including Medicare Advantage (MA) and managed...

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 – September 2020

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to...

Hospices Seek to Balance Technology with the Human Touch

By Holly Vossel | October 4, 2020 Hospices nationwide have leveraged technological advances to improve workflows, referral communications and enhance patient care. While telehealth in particular has been vital for hospices to continue reaching vulnerable high-risk patient populations during the COVID-19 pandemic, providers must proceed with caution when it comes to technology and patient...

CMS touts lower premiums and benefits of Medicare Advantage plans

Over 94% of Medicare Advantage plans will offer additional telehealth benefits, up from about 58% of plans offering telehealth benefits in 2020.  Susan Morse, Managing Editor More Medicare Advantage plans in 2021 will offer telehealth benefits. Average 2021 premiums for Medicare Advantage plans are expected to decline 34.2% from 2017...

53 Medicare Advantage Plans to Offer Hospice in 2021, Palliative Care to Grow

Among Medicare Advantage plans, 53 will be covering hospice and palliative care in 2021 through the value-based insurance design (VBID) model, according to the U.S. Centers for Medicare & Medicaid Services (CMS). Medicare Advantage is seeing record-high levels of participation for 2021 among beneficiaries, reaching about 42% for 2021,...

Medicare Advantage plans face ‘double whammy’ of pent-up care demand and risk scores: experts

Medicare Advantage plans need to figure out how the delay of care due to the COVID-19 pandemic will impact their risk scores in the long term, experts say. Many of the services that have been deferred by consumers would have made up the sources of diagnoses that plans would have...

New CMS Medicare Advantage Rule Creates Incentives for Providers to Invest in Telehealth

The Centers for Medicare & Medicaid Services (CMS) announced Friday it has finalized changes to Medicare Advantage (MA) and Medicare Part D. The changes — detailed in a final rule for 2021 — partly seek to strengthen access to telehealth services, an increasingly important component of the health care system amid...

CMS expands telehealth options for Medicare Advantage plans

A final rule published by the Centers for Medicare and Medicaid Services on Friday would allows Medicare Advantage plans to cover more specialties through telehealth. By ELISE REUTER Post a comment / May 22, 2020 at 4:41 PM The Centers for Medicare and Medicaid Services (CMS) will allow Medicare Advantage plans to...

CMS Finalizes Telehealth Reimbursement for MA Plans, ESRD Patients

The Centers for Medicare & Medicaid Services has issued a final rule on expanded telehealth coverage for members in Medicare Advantage plans and those living with end-stage renal disease. By Eric Wicklund May 22, 2020 – The Centers for Medicare & Medicaid Services is finalizing plans to expand telehealth coverage in Medicaid...

CMS Flexibilities to Fight COVID-19 – Medicare Advantage and Part D Plans

 Medicare Advantage and Part D Plans: CMS Flexibilities to Fight COVID-19 Since the beginning of the COVID-19 Public Health Emergency, the Trump Administration has issued an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019...

Telehealth Resources to Address COVID-19

What is COVID-19? Coronavirus disease 2019 (COVID-19) is a novel coronavirus that has not been previously identified. Symptoms include cough, difficulty breathing, fever, and mild to severe respiratory illness. According to the Centers for Disease Control and Prevention (CDC) the virus currently seems to be easily spreading throughout communities in the...

The Center for Medicaid and Medicare Services (CMS) – 2020 Medicare Learning Network Telehealth Services Booklet

MLN Booklet TELEHEALTH SERVICES ICN MLN901705 March 2020 Target Audience: Medicare Fee-For-Service Providers The Hyperlink Table, at the end of this document, provides the complete URL for each hyperlink. TABLE OF CONTENTS Originating Sites…………………………………………………………………………………………………………………. 3 Distant Site Practitioners…………………………………………………………………………………………………….. 4 Telehealth Services …………………………………………………………………………………………………………….. 4 Telehealth Services Billing and Payment……………………………………………………………………………… 7...
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