Debt Ceiling Agreement Likely To Impact Medicare
August 2011Medicare recipients and providers have shown grave concern in regard to the recently enacted debt-ceiling legislation, since the plan is likely to affect all government programs, including Medicare.
Executives at the American Hospital Association expressed their concern immediately. "Hospitals have repeatedly demonstrated a willingness to accept shared sacrifice and do what is best for our country, but our first commitment is to patients, whose access to care could be curtailed by further cuts to Medicare funding for hospital care," said AHA President and CEO Rich Umbdenstock in a press release.
MedeAnalytics, a leading provider of healthcare performance management solutions, released an estimate of the impact on Medicare payments to hospitals by recently enacted debt-ceiling legislation. MedeAnalytics experts predict that the budget reduction required by the legislation will result in provider reimbursement cuts of $1.1 to $1.4 million per year for each individual hospital.
Donna Enzmann, Vice President of Sales at MedSave USA, a record retrieval company contracted by Medicare providers, agrees with the assessment suggested by MedeAnalytics' report. Enzmann observed, "There's no question that Medicare will be impacted by this legislation. The bi-partisan committee has a substantial deficit to close, so all government program allocations– like Medicare its and provider reimbursements -- will be impacted. The big question is 'how much'?"
MedSave USA to attend "Mass Tort's Made Perfect"
MedSave USA will be attending "Mass Tort's Made Perfect" located at the Rittenhouse Hotel in Philadephia, PA, on Tuesday, May 24, 2011. They will be sending their two new litigation support professionals to learn of the current trends in the plaintiffs' legal arena and offer support in the discovery phase of prosecuting their cases. They are looking forward to meeting with current and potential clients at the evening's cocktail networking event. Seek them out and you will find out how MedSave USA can provide cost savings on plaintiff analysis of fact sheets, time and resources.
Medsave USA And MedeFile Join Forces To Market Web-Based Personal Health Record Solutions To Insurance Carriers
Global Insurer to Implement MedeFile Enrollments for World Travelers
April 2011MedeFile International, Inc. (OTCQB: MDFI), a leader in Internet-enabled Personal Health Record (iPHR) management solutions, and MedSave USA, Inc., one of the nation's leading providers of healthcare cost containment and medical record retrieval services, today jointly announced that the Companies will be partnering to actively market MedeFile's patient-centric iPHR system as a value-added service to MedSave USA's global client base, which are comprised of insurance companies, health insurance companies, healthcare providers, self-insured employers, third party administrators and government payer organizations.
New HIMSS Analytics Data Shows 44 percent of Hospitals Likely to be Ready for Stage 1 of Meaningful Use
Arlington, VA - (February 24, 2011) - New data from HIMSS Analytics indicates that 44 percent of hospital respondents fall within the "Likely" or "Most Likely" categories for meeting Stage 1 of meaningful use for Electronic Health Records conversions.
The interpretative scale for "meaningful use" is as follows:
"Most Likely": Hospitals with capability to achieve 10 or more Core measures and 5 or more Menu measures.
"Likely": Hospitals with capability to achieve 5-9 Core and 5 Menu; or 10 or more Core and 3-4 Menu.
Compliance with the Stage 1 meaningful use criteria is an essential prerequisite for a provider to qualifier for EHR incentives under HITECH. Based on the new HIMSS Analytics data:
- 44 percent of respondents fall within the "Likely" or "Most Likely" categories associated with achieving Stage 1 of meaningful use, as defined by HIMSS Analytics.
- Within this 44 percent of respondents, 58 percent of these respondents indicated they expect to achieve all meaningful use core measures by May 2012, which is the end of the period covered by the survey.
- Of the 999 hospitals that responded to the survey since May 2010, 25 percent already have the capability to meet 10 or more of the process core measures and at least five of the menu items.
- Of the 442 hospitals that responded to the survey since finalization of the criteria, 27 percent expect to achieve all 14 core measures and at least five of the menu measures by May, 2012 entitling them to the meaningful use incentives.
HIMSS Analytics expects an increase in these percentages as the deadline approaches for full compliance of Stage 1 of meaningful use. For hospitals to receive the full EHR incentive, through the Centers for Medicare and Medicaid Services' EHR Incentives Program, they must be meaningful users of certified technology by FFY2013.
HIMSS Analytics now has 24 questions on the Stage 1 Process Meaningful Use criteria included in its annual survey of more than 5,000 U.S., non-governmental hospitals. HIMSS Analytics began collecting data in May 2010. Following the finalization of the Stage 1 measures in July 2010, four additional questions were added to the survey. Hospitals are asked to indicate if they currently have the capability to achieve the 14 core measures and the 10 menu measures. If they do not currently have the capability to achieve a measure, they are asked what timeframe they expect to have the capability.
"As expected, the data indicates that hospitals well positioned to achieve the meaningful use criteria demonstrate high levels of EMR adoption as reflected in the HIMSS Analytics EMR Adoption Model. Further analysis of the data will be explored including EMR adoption as it correlates to meaningful use," said John P. Hoyt, FACHE, FHIMSS, Executive Vice President, Organizational Services, for HIMSS.
On February 18, 2011…CMS issued Advance Notice of Medicare Advantage (MA) capitation rate and risk adjustment methodology changes for 2012.
This initial release is open to public comment, before final county-level capitation rates are determined and reported on Monday, April 4th.
Initial 2012 Medicare Advantage plan rates
- Better then the market's expectation; CMS stated it believes the average Medicare plan will see rates rise by 1.6% in 2012.
- 2012 will see an increase in Medicare enrollment instead of the expected downturn in enrollment and profitability that was predicted.
- MA plans continue to increase their average risk score each year. CMS does not include this in their rate announcement, therefore it is estimated the actual rate increase in 2012 will exceed 3%.
Star Ratings update
- CMS stated it is considering making further changes to the star quality bonus demonstration project. For MA plans above 3 stars, CMS will consider applying a quality bonus % to the entire bended county rate instead of for 5 star plans. This is good news which will increase the importance of quality bonus payments. New MA plans and for existing MA plans without enough data to calculate the star rating, will be given 3 stars initially. CMS will focus more on outcome and patient experience measures rather than processes.
- Proposed acceleration of Star bonus payments: the full payment would be received in the first year instead of phased-in over a period of 2, 4, or 6 years (based on the county).
To read the full CMS rate announcement see the PDF file named "2012 Advance Notice"; click here:
http://www.cms.gov/MedicareAdvtgSpecRateStats/AD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=descending&itemID=CMS1244580&intNumPerPage=10
Annual Conference for the Council on Litigation Management
MedSave USA is attending the Annual Conference for the Council on Litigation Management, March 23 - 25, 2011 in New Orleans. For details, please see the conference website.
MedSave To Sponsor 5th Annual HCC Management Summit and First Annual Meeting of RISE
New York - MedSave USA, a leading national provider of record retrieval services, announced that the company will sponsor The 5th Annual HCC Management Summit and the First Annual Meeting of RISE (http://www.rasociety.org)in Nashville, TN from March 27-March 29th. The event is the industry's FIRST national association for risk adjustment professionals has teamed up with the industry's highest quality conference on HCC Management. For more information, log onto http://www.frallc.com/events/HCC/Default.aspx.
MedSave will be an event sponsor, speaker and exhibitor at the Summit.
RISE is the first national association totally dedicated to enabling healthcare professionals to meet the challenges of risk adjustment. The organization provides opportunities for networking, education, and industry intelligence.
MedSave USA is a leading provider of record retrieval services, offering enhanced technologies that cater to the specialized medical record retrieval needs of the healthcare market, insurance sectors, and legal industry.
Partnership to Offer NSHC Members Savings
(February, 2010 - Nassau-Suffolk County) The Nassau-Suffolk Hospital Council entered into a partnership in February 2010 with MedSave USA Inc., a Hauppauge-based corporation offering medical record retrieval services to Hospital Council members. MedSave delivers a secure, web-based application for retrieval and delivery of documents demanded for malpractice claims, Medicare, Medicaid and private payer audit and other purposes that can help hospitals reduce costs and alleviate the burden on hospital staff.
Medicare Advantage Plan Star Ratings Optimization
On November 10, 2010, the Centers for Medicare and Medicaid Services (CMS) released an update of the proposed rule changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Programs for 2012 and a 3 year Demonstration Project on Quality Bonus Payments.
The final rule will be published in spring 2011 and most provisions will be in effect 60 days after the final rule is published. CMS is posting the 2011 Medicare Plan Star Ratings which includes a 3-year Demonstration Project that accelerates quality bonus payments for 4- and 5-star MA plans and adds quality bonus payments for 3- and 3-1/2 star plans. The Affordable Care Act (ACA) introduces quality bonus payments in order to implement quality improvement into the Medicare Advantage program.
Highlights of these Medicare program updates include:
- Quality bonuses will be paid beginning in 2012, to MA plans that earn 4 or more starts in a 5-star quality rating system.
- MA plans that earn 4 or 5 stars will get the same % bonus.
- MA plans that earn less than 4 stars will get no bonus.
- Under the 3-year Demonstration Project, which starts in 2012 and ends in 2014, MA plans which are rated at 5 stars will be paid a greater bonus payment than 4 star plans.
- MA plans that are rated at 3 and 3-1/2 stars will receive lower bonus amounts in payments.
- CMS will approve stronger applicants for Parts C and D program participation and will remove consistently poor plan performers.
- Plans that receive fewer than 3 stars for 3 consecutive years will have a "low performer" icon affixed to its plan name on the CMS Medicare Plan Finder website.
The 3-year demonstration project will test whether the scaled bonus payments will lead to quicker and larger year-to-year quality improvements in the MA program quality scores.
See full article here:http://www.cms.gov/apps/docs/Fact-Sheet-2011-Landscape-for-MAe-and-Part-D-FINAL111010.pdf