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黑料不打烊 Insights: Your source for healthcare news, ideas and analysis.

黑料不打烊 Insights鈥攊ncluding briefs, webinars, and our podcast鈥攇ives you easy access to 黑料不打烊鈥檚 deep expertise, helping you stay current on the latest healthcare trends and topics. Search for a topic of interest or browse the latest insights below.

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黑料不打烊 releases COVID-19 Medicare regulation tracking tool

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The Medicare program has rapidly transformed how it pays for healthcare providers in response to the COVID-19 pandemic. In an effort to capture these changes, 黑料不打烊, commissioned by 听补苍诲听, tracked, categorized, and analyzed the 212 Medicare policy modifications made in response to the public health emergency.

黑料不打烊 Senior Consultant聽Jennifer Podulka聽and Managing Principal聽Jon Blum聽led efforts to analyze and synthesize COVID-19-related legislative, regulatory, and subregulatory changes to existing Medicare regulations issued beginning January 1, 2020. The resulting issue brief聽Regulatory Changes to Medicare in Response to COVID-19聽and companion Policy Tracker use nine categories to organize the data and will be periodically updated to include new information.

The issue brief outlines key COVID-19-related changes including providing telehealth reimbursement for more types of services and providers, and waived conditions of Medicare participation permitting patients to be treated in alternative care settings including community facilities, temporary facilities, homes and in some cases, out of state services on a temporary basis.

Congress and the Trump administration waived or changed regulations to allow flexibility to help healthcare providers, Medicare Advantage plans and Part D plans. The policy tracker catalogs and categorizes these regulatory changes based on characteristics, including types of providers and plans affected, effective date, and expected duration.

These changes have affected virtually all healthcare providers and health plans that participate in the Medicare program, and the issue brief examines several questions surrounding the changes moving forward including risk to beneficiary protections and Medicare spending controls established in the original legislation and rules.

Hawaii Releases Quest Integration Reprocurement RFI

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This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state鈥檚 QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360,000 individuals, including pregnant women, children, parents/caretakers, adults, and individuals who are aged, blind, or disabled (ABD). The state had awarded contracts earlier this year, however, the contracts were rescinded as the state focused on their response to COVID-19.

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Webinar Replay: Exploring Medicare Advantage Plans as a New Business Strategy

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This webinar was held on August 6, 2020.

The COVID-19 pandemic shined a spotlight on funding pressures on providers and systems that rely largely on fee-for-service payment. This, along with additional stressors brought on by the pandemic, has led many health systems and providers to consider revenue diversification and service expansion strategies. During this webinar, 黑料不打烊 Medicare Advantage experts addressed the option of using Medicare Advantage as a strategy to better manage care of patients and provide a steady stream of predictable revenues.

Learning Objectives:

  • Evaluate the benefits and risks of exploring a Medicare Advantage business strategy.
  • Understand the evolving national Medicare Advantage policy landscapes and competitive marketplace.
  • Assess various Medicaid Advantage plan options and strategic business considerations.
  • Find out about the unique market opportunities of Medicare Advantage Special Needs Plans.
  • Learn what needs to be done for a successful Medicare Advantage launch or expansion in 2022.

黑料不打烊 Speakers

Jon Blum, Managing Principal, Washington, DC
Mary Hsieh, Managing Principal, Atlanta, GA

Webinar Replay: Leveraging the Primary Care Team鈥檚 Strengths During Reopening: Part 3 – Payment and Documentation

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This webinar was held on July 29, 2020.

In this webinar, 黑料不打烊 primary care experts discussed current payment flexibilities that allow physician practices to maintain revenues while operating in a virtual environment. Given the likelihood that many patients will continue to receive care virtually even after the pandemic, 黑料不打烊 experts explored mechanisms for alternative payment models that support virtual care and allow for efficient use of the care team. Speakers also shared necessary considerations for documentation to assure data capture and appropriate billing.

Learning Objectives

  1. Discuss current relaxation of regulations related to the National Emergency Declaration and CMS flexibility.
  2. Understand the use of alternative payment models to enhance revenue opportunities for practices providing virtual care.
  3. Understand the need for new templates and order sets to support virtual care.
  4. Discuss EHR optimization to improve care processes and capture data.

Speakers

Helen Duplessis, MD, Principal, Los Angeles, CA
Lisa Harrison, MS, MHS, PA-C, Senior Consultant, Denver, CO
Roxane Townsend, MD, Managing Principal, Raleigh, NC

Oklahoma releases Medicaid managed care request for public feedback

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This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state鈥檚 Medicaid managed care program design before finalizing a request for proposals (RFP). The RFP, which is currently in development, is scheduled to drop in the fall and has an implementation date of October 2021. Individuals, program participants, providers, trade associations, companies, and other organizations are encouraged to submit responses by August 17, 2020.

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Webinar Replay: Nursing Home Revenue Diversification and Care Options Series: Understanding the Impact of Nursing Home Compare Five-Star Quality Ratings

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This webinar was held on July 24, 2020.聽

Even before COVID-19, nursing homes struggled with staffing shortages, inadequate reimbursement rates, and declining occupancy rates. The pandemic has amplified these challenges, forcing nursing homes to consider options for diversifying revenues and broadening services for both residents and individuals who qualify for institutional status but reside in the community. During this webinar (the second in a series), 黑料不打烊 quality experts will provide an overview of the Nursing Home Compare Five-Star Quality Rating System and its impact on nursing homes.

Learning Objectives

  • Understand the components of the Nursing Home Compare Five-Star Quality Rating System.
  • Find out how Nursing Home Compare ratings impact a nursing home鈥檚 business.
  • Learn the strengths and limitations of Nursing Home Compare as a true measure of nursing home quality.

黑料不打烊 Speakers
Doug Elwell, COO, Chicago, IL
Susan Tucker, Principal, Tallahassee, FL

Webinar Replay: Leveraging the Primary Care Team鈥檚 Strengths During Reopening: Part 2 – Adapting the Environment

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This webinar was held on July 22, 2020.

Before reopening for in-person visits, primary care practices must address a wide variety of safety considerations, including infection control protocols; modifications to offices, waiting areas, and exam rooms; staffing and workflow issues; and other strategies that minimize the risk of exposure to COVID-19 for both patients and staff. During this 30-minute webinar, 黑料不打烊 primary care experts discussed best practices for successfully reopening primary care practices during the COVID-19 pandemic.

Learning Objectives

  1. Understand key clinical, physical office, and financial considerations for reopening primary care practices to in-person patient care.
  2. Learn about the availability of decision-support tools and resources to assist primary care practices with reopening.
  3. Find out about infection control protocols and other best practices to ensure the safety of patients and staff during reopening.
  4. Learn how the 鈥渘ew normal鈥 of operating during the COVID-19 pandemic variously impacts clinicians, administrative staff, and leadership, including a look at new protocols and workflows.

Speakers

Karen Hill, PhD, ANP-C, MSN, RN, Senior Consultant, San Francisco, CA
Brittany LaBarreare, Senior Consultant, Austin, TX
Gail Mayeaux, Principal, Albany, NY
Deb Peartree, Senior Consultant, Albany, NY

Early Bird Registration Expires July 29 for 黑料不打烊 Conference, October 26-27 in Chicago

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Be sure to register soon for 黑料不打烊鈥檚 conference on What鈥檚 Next for Medicaid, Medicare, and Publicly Sponsored Healthcare: How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty, October 26-27, at the Fairmont Chicago, Millennium Park. The Early Bird registration rate of $1595 per person expires on July 29.聽 After that, the rate is $1795.

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