Health Care Insights | Weekly Round Up

Health Care Insights brings you your weekly healthcare round up. Below you will find relevant articles on key industry topics that we thought our readers would benefit from - enjoy.

Top Stories:

CMS Says Some Providers are Obstructing Dual-Eligible Demonstration
The CMS official in charge of coordinating care for Americans covered by both Medicare and Medicaid says some healthcare providers are illegitimately trying to dissuade dual-eligible beneficiaries from participating in a managed-care initiative designed to test ways to reduce costs and improve quality. She said her agency has increased its surveillance of these providers, though she did not identify any by name.

Plans Say Duals Bring Down Star Ratings, Beneficiary Advocates Not Convinced
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As CMS looks at possible changes to the Medicare Advantage star ratings program, health plans say that poorer beneficiaries are causing lower-than-appropriate star ratings for some MA plans, though the Medicare Rights Center says that current data do not show that beneficiaries' low income is the root cause of lower quality care for those beneficiaries.

Work Group Submits Comments to CMS on Sovaldi, Breakthrough Therapy Designation Medications
The Medicaid Work Group sent a comment letter to the Centers for Medicare and Medicaid Services on the introduction of Sovaldi and other new  Breakthrough Therapy Designation medications and their potential impact on Medicaid costs.

Vitamin B Doesn't Reduce Cognitive Risk in Healthy Elderly
Lowering plasma homocysteine levels with oral vitamin B12 and folic acid does not appear to be an effective strategy for reducing memory loss and Alzheimer's risk, according to findings from a randomized, clinical trial of elderly people in the Netherlands with elevated homocysteine.

Joint Commission Report: U.S. hospitals are getting better, but there is still room for improvement
If the Joint Commission‘s assessment of a hospital is any indication – and by just about all accounts, it’s the indication – hospitals across the U.S. are improving, with more than 1,200 having achieved “top performer” status. A total of 1,224 made that cut, an increase of 11 percent from last year. The top performers represent nearly 37 percent of more than 3,300 Joint Commission-accredited hospitals that contributed data, according to its annual report.



Have a great weekend!

Health Care Insights | Weekly Round Up

Health Care Insights brings you your weekly healthcare round up. Below you will find relevant articles on key industry topics that we thought our readers would benefit from - enjoy.

Top Stories:

A Post-Election Day Certainty: New Scrutiny for the Affordable Care Act
This week’s elections ensure a new round of political attacks on the Affordable Care Act, but they also create potential opportunities to repair provisions of the law that people on both sides of the partisan divide would like to fix.

Big data: Enabling the Future of Healthcare
Everyone’s talking about the importance of big data in healthcare. Yet, as the data piles up – most of it is isolated in different silos, and health systems are struggling to turn big data from a concept into a reality. Here’s how I see it having a substantial impact on the health of populations, today and in the future.

Electronic Medical Records, Built For Efficiency, Often Backfire
Electronic medical records were supposed to usher in the future of medicine. Prescriptions would be beamed to the pharmacy. A doctor could call up patients' medical histories anywhere, anytime. Nurses and doctors could easily find patients' old lab results or last X-rays to see what how they're doing. The computer system could warn doctors about dangerous drug combinations before it was too late.

Steward’s ACO focuses patient engagement efforts on 4 percent of covered lives
According to Girard, there are two fundamental processes in healthcare, information flows and people flows. The ideal, he said, is for both processes to be happening at the right time in the right place.

Coordinated care and patient engagement
The healthcare breakthrough of the 21st century may not come in the form of a miracle drug from the pharmaceutical industry. Rather, it's more likely to emerge from the ways caregivers interact and motivate patients.


Enjoy the weekend!

7 Reasons Why You Need to Attend MDRP in September

Government rules and regulations affect every department at a pharmaceutical company and within the past few years, interconnectedness between government programs, commercial contracting, finance and legal departments has become more evident, and more important. This year's looming rules and regulatory changes from CMS, HRSA, and OIG and the impact of the ACA could completely change the way you conduct government-related operations.

IIR's Medicaid Drug Rebate Program Summit has become THE authoritative MDRP event for everything government pricing, rebates and regulation, because it brings together all the pieces you need to succeed-regulatory updates, 550+ MDRP executives, and 20+ solution providers across three days.

Specifically here are 7 reasons reasons no MDRP Executives can miss out:

1. Get essential regulatory and ask questions of key federal and state government officials such as HRSA, OIG, CMS & more

2. Direct access to 13 State Rebating Representatives
o Realize millions in potential savings through face-to-face meetings with States by signing up for the exclusive Dispute Resolution Meetings and leave Chicago with money back for your company

3. Overcome challenges in the current legal landscape and ensure compliance with government program mandates affecting manufacturers in the new Legal & Compliance Track

4. Earn both Continuing Legal Education (CLE) and CPE credits for the first time

5. Understand the true impact of the ACA and Medicaid reform with 2 Industry Keynote speakers

6. Hear from Texas, Utah, Illinois and more in the State Spotlight session in the Price Calculation and Contracting Strategy Track

7. Sharpen Your GP Skills in Four Focused Pre-Conference Summits

Download the brochure for the complete summit and session details.

This is the largest government pricing and reimbursement event in the industry-and its the only event your peers buzz about. Click here to save your seat now or call 888-670-8200. Be sure to use Priority Code: XP1958BLOG to save $100.

Rates go up this Friday, August 8th | Register for MDRP Now to Save up to $300

In the last few years, interconnectedness between government programs, commercial contracting and finance departments has become more evident, and more important. Transparency is integral to the company’s bottom line, and government pricing and contracting executives play a key role that financial executives are taking notice of.

IIR's 19th Annual Medicaid Drug Rebate Program Summit has continued to be THE event effectively bringing together experts across all of the three functions to benefit learning from each other; enabling them to work more efficiently and effectively.

This year, we have two tracks—Price Calculation and Contracting Strategy and Financial Implications to Government Pricing Programs that will provide expert insights into the overarching financial implications to what you do each day.

Track highlights include:

Price Calculation and Contracting Strategy:   
• The only track providing you a ‘state spotlight’ from Texas, Oklahoma, Utah & Illinois
• Hear firsthand from a working group including pharma manufacturers & state representatives as they shed light on best practices on resolving and avoiding disputes
• Health care reform impact on government pricing, commercial business & contracting strategies

Financial Implications to Government Pricing Programs:
• Panel discussion by pharma manufacturers from Eli Lilly, Daiichi Sankyo, AstraZeneca, and Vertex on the developments in the split between managed Medicaid and fee for service
• Operational strategies for Medicaid rebate invoices and reporting regulations
• 340 B compliance, monitoring & auditing

Download the updated brochure for full agenda and speaker details.

Don't miss out on the largest government pricing and reimbursement event in the industry! No other event provides you with access to this many government agencies who directly impact your business. Click here to save your seat now.

Don't forget! Blog readers receive an EXTRA $100 off the current rate – So register by August 8th to save up to $300! Click here to register now or call 888-670-8200. Be sure to use Priority Code: XP1958BLOG

I hope to see you and your team this September 15-17, 2014 in Chicago.

Where is CMS Heading?

Over the year, a lot has changed in healthcare. As the final rule continues to hang on the horizon, what is needed for all of the players in the healthcare industry to implement change quickly? Learn more from CMS at MDRP 2014 to make sure you have adequate information to launch your program changes efficiently.

At MDRP 2014 get essential regulatory updates from key federal government officials. From the Center for Medicaid Services (CMS) you will receive updates on:

• MDRP Compliance & Current Reporting – Kim Howell, Department Director, Division of Pharmacy, Department of Health and Human Services, CMS 
• Medicare Part D Proposed Rule – Tracey McCutcheon, Deputy Director, Medicare Drug Benefit Group, CMS

Download the complete agenda.

And make sure you join us September 15-17 in Chicago to prepare for the AMP Final Rule and deconstruct Part D and 340B Mega Rule.

Remember as a blog reader you can save an EXTRA $100 off the current rate when you register with the code: XP1958BLOG

Register now.

Model health care sites opening across the nation

Rachel Zimmerman of Common Health looks at Donald Berwick, who is the new Director of Centers for Medicare and Medicaid Services, and his plan to expand model healthcare sites across the United States. The goal is to have these sites launched throughout the US by the end of 2011. These sites will focus on the safety of patients and quality care while maintaining an affordable cost. They will be the new model for how physicians are paid with the new plans for healthcare.

Jonathan Blum, Director of the Center for Medicare Management Joins The Medicare Congress!

The Medicare Congress Team is pleased to announce our latest addition to the speaking faculty:

Keynote Presenter Jonathan Blum, Director of the Center for Medicare Management (CMM), and Acting Director, Center for Drug and Health Plan Choice (CPC) at the Centers for Medicare and Medicaid Services. Don’t miss his Keynote Address at 8:45 AM on Thursday, January 21, on the CMS Regulatory Outlook for Part D and Medicare Advantage Programs in 2010 and Beyond.

Now, with final negotiations beginning on the Senate and House versions of the Healthcare Reform Bill, changes to Medicare as we know it are inevitable. Don’t be left behind by your competitors - Join us at the year’s most respected Medicare event to arm yourself with the tools needed to prove the merit of MA, increase profitability, and deliver value in an increasingly member-centric Medicare system.

Over 40 of the nation's leading Health Plan CEOs and Medicare Directors are already attending, including Aetna, American College of Physicians, BlueCross BlueShield, Essence Healthcare, Gorman Health Group, Healthcare Partners, Henry Ford Health System, Kaiser Permanente, United Healthcare, Universal American, and WellPoint. Click here to view the full list.

The 7th Annual Medicare Congress is designed with your entire team in mind, so find out about group discounts and register by this Friday, January 8th, to maximize your savings.