Today’s Hot Topics in Medicare News

2020 Medicare Physician Fee Schedule: What You Need to Know

BY SHAWN MARTIN: On July 29, CMS released the 2020 Medicare physician fee schedule proposed rule.(s3.amazonaws.com) This proposal sets forth changes in payment values and quality/performance reporting requirements for family physicians participating in Medicare. The proposed rule also impacts the Quality Payment Program.

The AAFP has published a summary (4 page PDF) of the proposed fee schedule. You also may find value in CMS fact sheets on proposed changes to the fee schedule (www.cms.gov) and the QPP.(www.acr.org) If you have questions or comments on the fee schedule to address to the AAFP, please email [email protected] (read more)

ACOs Save More Compared to Medicare Advantage, Report Finds

BY JACQUELINE LAPOINTE: The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers, while the latter is incurring costs, a new report in Health Affairs finds.

“Our examination of the literature indicates that Medicare Advantage ‘costs’ Medicare; that is, when a beneficiary joins MA, Medicare spends more, on average, than it would have if the patient had remained in traditional Medicare. We find the opposite in the MSSP: When a patient joins the Medicare ACO program, Medicare costs fall,” researchers from Aledade stated in the report(read more)

Use the EHR to help your Medicare patients with prediabetes

BY AMERICAN MEDICAL ASSOCIATION STAFF WRITER: Electronic health records are an effective way to create registries for referring patients with prediabetes to prevention programs, according to recently published findings from a Medicare demonstration project.

Use of an EHR-based registry is among the methods covered in the AMA’s Diabetes Prevention Guide, which supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. (read more)

Using Data Analytics to Reach Five-Star Medicare Quality Measures

BY KELSEY WADDILL: Over three years ago when Yvonne Krashkevich became director of quality and accreditation at Geisinger Health Plan, the multi-faceted nature of Medicare quality measures was an enigma to the Pennsylvania-based health plan.

The key quality measurements that health plans have to consider are many, Krashkevich said in an interview with HealthPayerIntelligence.com, and include the Health Outcomes Survey (HOS), the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, Healthcare Effectiveness Data and Information Set (HEDIS), the pharmacy and operational measures, and the clinical services measurements. (read more)

When Medicare Stops Covering a Test Without Warning

BY HANS DUVEFELT, MD: There are two versions of “the conversation” we have with men: One is for teenage boys, and it is about wet dreams, sexually transmitted disease, unwanted pregnancy, and at one point also about testicular self-examinations. Those have now been edited out of the script, which makes sense to me since I have seen only three cases of that in forty years of practice, all but a couple of them diligently preaching that particular gospel.

The other one is with men of the age I now am, explaining, a few years ago, the benefits of blood tests (and, remember the rubber glove exam?) for prostate cancer screening and more lately the confusing intricacies of PSA blood tests. (read more)


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