Nearly half of hospitals to get lower Medicare payments due to patients' readmission history; open enrollment begins for health coverage under the Affordable Care Act; study models projected cases and deaths from COVID-19 to the president's rallies.
Medicare Fines Hospitals for Readmitting Too Many Patients
Reported by Kaiser Health News, nearly half of hospitals in the United States will get lower payments for all patients covered by Medicare due to their history in readmitting patients. The fines, indicated by federal records, are the ninth annual round of the Hospital Readmissions Reduction Program implemented through the Affordable Care Act’s effort to improve quality and lower costs. The latest penalties come amid surges in cases of coronavirus disease 2019 (COVID-19) and resulting financial fallout, but were calculated based on each hospital case history before the pandemic, from July 2016 to June 2019. CMS announced in September they may suspend the program in the future if it proves too difficult to assess hospital performance amid the pandemic.
Open Enrollment Begins for ACA Plans; Georgia to Stop Using HealthCare.gov in 2023
Open enrollment for plans under the ACA began Sunday, but the Trump administration is not promoting the plans despite this being the first open enrollment period to occur in the midst of a pandemic that has caused widespread job loss. Even with the lack of publicity, Politico reported that most observers expect enrollment to hold steady. Separately, CMS Sunday night approved a plan to allow Georgia to stop directing people to healthcare.gov in 2023, sending them instead straight to insurance companies and private brokers.
Study Examines Trump Rallies' COVID-19 Spread
A statistical modeling study from Stanford University indicated that 18 of President Donald Trump’s campaign rallies held between June 20 and September 22, 2020 have led to over 30,000 confirmed cases of COVID-19, likely leading to over 700 deaths. The New York Times reported researchers compared spread of the virus in the counties that held the rallies to other counties that were similar in case trajectory before the rallies occurred, of which only 3 were held indoors. Study findings come amid a single-day record for cases of COVID-19 this past Friday, amounting to 97,080 new cases.
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
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Insurance Coverage Limits JAKi Therapy Access for Patients With AA, Especially Non-White Populations
April 25th 2024A survey study showed major barriers to Janus kinase inhibitor (JAKi) therapy for patients with alopecia areata, especially for non-White patients who face higher rates of being uninsured and struggle more to afford the treatment.
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