Health Care Policy, Quality, & Payer Administration Archives - Page 2 of 193

Clinical Consistency, It Matters

Article June 12, 2023

Clinical “consistency” is a key quality issue. Defined as “treating similar conditions in a similar manner,” organizations with clinical consistency reduce variability, are more likely to improve consumer health, produce… Read More

Planning For 10.1%

Article June 5, 2023

Last week, the Congressional Budget Office (CBO) released new estimates quantifying the extent to which the “unwinding” of COVID Medicaid eligibility and Marketplace subsidy policies will affect Americans’ health care… Read More

Be Careful What You Ask For

Article May 29, 2023

Our most recent analysis, U.S. Behavioral Health Spending: A 2023 OPEN MINDS Market Intelligence Report, found that behavioral health spending has increased—a lot—over the past decade. At $329 billion in 2022, there has… Read More

Over Half Of Young Adults Concerned About Their Mental Health, But Only 12% Of Adults Report Mental Health Visits

Article May 22, 2023

Among adults ages 18 to 32, 60% said they were concerned about their mental health in response to a CVS Health/Harris Poll survey. However, only 12% reported visiting a psychiatrist,… Read More

CMS Finalizes Medicare Advantage Prior Authorization Reforms

Article May 22, 2023

On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) finalized its proposals to reform Medicare Advantage plan prior authorization policies to improve transparency. The new regulations are… Read More

Demographics Are Destiny

Article May 22, 2023

Another milestone. Enrollment in Medicare Advantage surpassed traditional Medicare for the first time. As of January, 2023, 30.19 million of the 59.82 million people eligible for Medicare were enrolled in… Read More

When To Say When

Article May 15, 2023

Reimbursement for health care services is all over the map. For example, Medicaid home health aide reimbursement varies from $13 to $148 per visit across the country. And the per-hour… Read More

The Carve-Out/Carve-In Question

Article May 15, 2023

The number of state Medicaid plans using primary carve-outs models for the financing and delivery of behavioral health services have dropped significantly, from 15 states in 2011 to 8 states… Read More

Biden-Harris Order To Link Nursing Home Medicare Payments To Staff Retention Rates

Article May 8, 2023

On April 18, 2023, the Biden-Harris Administration issued an executive order focused on increasing access to high-quality long-term care and supporting caregivers of people needing long-term care. A key provision… Read More

Cost Of 30-Day Hospital Readmission 6% Higher Among Those With Alzheimer’s

Article May 8, 2023

The cost of a 30-day hospital readmission following hospital discharge was 5.9% ($467) higher for those with Alzheimer’s disease and related dementias (ADRD) than people without ADRD, according to an… Read More

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