Tag: Medicare

The April 2019 CMMI Proposals for Innovative Payment Models

Portrait of Dr. Joanne Lynn

By Joanne Lynn May 7, 2019 CMMI has announced that they will soon call for proposals for a bevy of new payment models, aiming to reduce hospitalization without harming quality by allowing a great deal of flexibility by practicing primary care clinicians for Part A and Part B services in Medicare and by allowing contracting

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A New Focus on Supports in Medicare – Supplemental Benefits 2020

Portrait of Dr. Joanne Lynn

By Joanne Lynn “Starting in 2020, we are going to be expanding that range of [Medicare Advantage] benefits…to include home modifications, home-delivered meals, and more.” — Alex Azar, Secretary of HHS [The Root of the Problem: America’s Social Determinants of Health, November 14, 2018, as prepared for delivery] Aha! Medicare leadership is awakening to the

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States Move to Chart a Path for More Reliable, Affordable LTSS

portraits of Anne Montgomery and Sarah Slocum

By Anne Montgomery and Sarah Slocum On May 4, 2018, the Michigan State Legislature voted to “just do it:” to assemble a group of experts to craft a blueprint for taking the Wolverine State deep into the future of Michigan’s age wave – all the way through the mid-21st century. Specifically, the language requires the

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MediCaring Communities Proposal Shows Substantial Savings in Medicare Costs

New York, New York, July 5, 2016—A new financial simulation for a novel model of care, called MediCaring Communities, has shown significant Medicare savings for frail older adults who need both medical care and nonmedical support services. Medicare savings ranged from $269-$537 dollars per person per month, depending on the community, its past patterns, and

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Could MACRA Enable Care Models That Serve Frail Elders Well?

By Joanne Lynn Medicare fee-for-service (FFS) beneficiaries with advanced illnesses and worsening disabilities, and the clinicians who focus on serving them, could wind up becoming big losers if MACRA (Medicare Access and CHIP Reauthorization Act of 2015) is implemented without sufficient attention to the realities of caring for these vulnerable populations. But there are ways

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Moving a Medicare Reform Agenda for Frail Beneficiaries: Let’s Do It

By Joanne Lynn and Anne Montgomery For a rapidly aging U.S. population, our current care system has its priorities upside down. It is calibrated to address heart disease and cancer as well as possible, with customized drugs, specialist hospital-based doctors, and 9-1-1 rapid responses. In short, we have a system that is built on the

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Sixth White House Conference on Aging: Now It’s Time to Do More. A Lot More.

By Anne Montgomery Around the country, people at more than 600 “watch parties” gathered to tune into a livestream of the White House Conference on Aging (WHCOA) [http://www.whitehouseconferenceonaging.gov] on Monday, July 13, 2015. Hosted by the White House in the East Wing and the Eisenhower Executive Office Building with an invited audience of about 200

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Just How Dysfunctional is Frail Elder Care in the U.S.?

By Joanne Lynn Very, very dysfunctional. You need evidence? Try these two tales. First, a remarkably illuminating piece of research was released on March 2 concerning the Meals on Wheels program (http://www.mealsonwheelsamerica.org/docs/default-source/News-Assets/mtam-full-report—march-2-2015.pdf?sfvrsn=6). The title was “More than a Meal,” and it showed that people who got warm meals home delivered by volunteers 5 days per

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Purchasing Value – Not Yet Right for Medicare’s Frail Elders

By Joanne Lynn In late January, Department of Health and Human Services Secretary Sylvia Matthews Burwell announced that Medicare would purchase most services on the basis of value rather than volume, aiming for 90% of fee-for-service payments by 2018 [http://www.hhs.gov/blog/2015/01/26/progress-towards-better-care-smarter-spending-healthier-people.html]. Of course, paying on the basis of value is much better than paying on the

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The Evidence That the Readmissions Rate (Readmissions/Hospital Discharges) Is Malfunctioning as a Performance Measure

Dr. Joanne Lynn Portrait

By Joanne Lynn M.D. [Also see companion post by Stephen F. Jencks, M.D., M.P.H.] Care transitions improvement programs have been effective in helping the health care system both become more effective in serving people living with serious chronic conditions and reduce costs. However, the key metric used to measure performance is seriously malfunctioning in at

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