Second Guessing Medicare’s Star Rating System

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But insurance executives made them a priority after the 2010 healthcare law attached large financial rewards to them. The first round of ratings last fall showed that most have a long way to go. Only 12 earned a perfect score of five, on a scale of one to five, and about 9 percent were below average. The majority received scores of three, or three and a half stars– enough to get them bonus money this year. After 2014, plans will need four or five stars to get bonuses. And if they have fewer than three stars, they won’t be allowed to enroll beneficiaries through Medicare’s website, and risk being booted from Medicare altogether, according to HHS spokesman Tony Salters. 
Source: kaiserhealthnews.org

Video: CMS 2013 Star Ratings Best Practices Webinar (5 of 5)

CMS Conducts Star Ratings Best Practices Webinar

Health plan representatives described approaches they have taken to create a culture of quality, to establish quality-based frameworks, and to use various capabilities to make improvements when administering care.  Many of the presenters highlighted innovative outreach techniques they have implemented to engage patients and enhance member satisfaction.  Presenters also focused on their organizations’ goal to meet the “triple aim” framework developed by the Institute for Healthcare Improvement (IHI):  (1) improving the patient experience of care (including quality and satisfaction); (2) improving the health of populations; and (3) reducing the per capita cost of health care.
Source: healthlawpolicymatters.com

All about CMS Star Ratings And Why It Matters

CMS is launching a 3-year demonstration with progressive bonus payments based on ratings, as well as offering bonus payments to plans with average ratings. CMS is also launching a demonstration beginning in 2012 that will last for 3 years, and will increase the size of the bonus payments to these high rated plans (4 or more stars), and will also provide bonuses to plans who have average ratings (3 to 3.5 stars). The intent of the demonstration is to encourage plans at all levels of performance to work on quality improvement, and to test the impact on scaled bonuses on expediting year-over-year improvement across plans, in comparison to the health reform law payments.
Source: 2014medicareadvantage.com

CMS Quality Star Ratings Offer Opportunity for Adherence Evidence Generation

accountable care Accountable Care Organization ACO anesthesia ARRA CAC care management CDI clinical documentation CMS coding collaborative care computer-assisted coding consumer engagement EHR Emergency Department employee health EMR european healthcare Healthcare Healthcare Audits health care costs healthcare europe Healthcare Information Exchange healthcare information technology Healthcare IT healthcare IT interoperability healthcare reform healthcare reform legislation health savings health savings tools health system HEOR HIE HIMSS HIPAA HIS HIT HITECH HIT Interoperability hospital hospital cio hospital consolidation HSA ICD-10 ICD10 inpatient care Interoperability interoperability showcase ISPOR life sciences Meaningful Use meaningful use guidelines Medicare natural language processing NLP Optum Patient Care patient consent Patient Satisfaction payer Perioperative perioperative care pharma pharmaceuticals Pharmacoeconomics physician Physicians population health Population health management population management provider RAC risk management sharing risk
Source: healthcare-exchange.com

Colorado Makes Medicaid Expansion law of the land

Posted by:  :  Category: Medicare

As year’s turn to months, and soon to days until the most contentious parts of Obamacare is implemented, Many Governors are now starting to sign various Medicaid Expansion bills into law. As such is the case in the state of Colorado, Democratic Gov. John Hickenlooper signed the Medicaid Expansion measure into law outside the States Capitol. Gov,. Hickenlooper said “This is going to support working Coloradoans and improve economic security for individuals and families and ultimately even for businesses,”
Source: medicaidexpansion.com

Video: Medicaid: Expanding Care for Colorado

Medicaid Expansion in Colorado Means More Opportunities for Job Seekers

Patients are not the only beneficiaries of this new law. The Medicaid expansion is also projected to be a boon for health care job seekers as more people access health care. In fact, The Colorado Health Foundation recently conducted a study on the economic impact of Colorado’s Medicaid expansion. Their analysis forecasts that 14,357 jobs will be added to the Colorado economy in the first 18 months following expansion (i.e. January 1, 2014 – June 30, 2015). Most of these jobs are predicted to be in the direct health care sector.
Source: missiondrivencareers.org

Colorado Springs Independent

I have not heard of any proposal by the government or anyone else that your guns are going to be confiscated. It is almost laughable. Can you imagine our government trying to round up over 100 million guns (probably a conservative figure). It would be impossible. Thus your Second Amendment rights will remain intact.
Source: csindy.com

Current Medicaid Patients Will Miss Out on Better Preventive Care In 2014

In fact, the researchers found that many Medicaid rules contained confusing language indicating that coverage of any procedure, including preventive testing and counseling, would be denied without proof of “medical necessity.” By definition, the authors explain that preventive services cannot be described as medically necessary because they are intended for patients who are not yet showing symptoms of the diseases they are intended to detect.
Source: kaiserhealthnews.org

The Case for Medicaid Self

In recent years, self-direction has emerged as a game-changing strategy in organizing and delivering Medicaid funded services, a means of affording people with disabilities enhanced opportunities to live fulfilling lives of their own choice in local communities. Yet, despite the growth in self-directed services, many key questions remain to be answered about the most effective ways of promoting individual choice and control within a Medicaid funding environment.  This paper from the National Council on Disability summarizes key study findings, conclusions, and recommendations.
Source: alliancecolorado.org

Colorado Springs Independent

I have not heard of any proposal by the government or anyone else that your guns are going to be confiscated. It is almost laughable. Can you imagine our government trying to round up over 100 million guns (probably a conservative figure). It would be impossible. Thus your Second Amendment rights will remain intact.
Source: csindy.com

Policy Speakout: Medicaid expansions will help Colorado’s economy

Established in 1965, Medicaid has functioned as a jointly-funded federal and state government health program. Currently, more than 670,000 Colorado citizens are enrolled in Medicaid, with 60 percent being children and 18 percent being the aged or individuals with disabilities. Medicaid expansion would enable Coloradans to qualify for Medicaid coverage provided they fall under 138 percent of the federal poverty level (FPL). The level equates to an annual income of $15,415 for a single individual and $31,809 for a family of four.
Source: typepad.com

Hickenlooper Expands Medicaid But Cost Remains Unknown

The cost, Hickenlooper said, would be paid by the federal government until fiscal year 2016-2017 when Colorado will pick up 10 percent of the tab. He said the estimated $128 million cost over the next 10 years will be offset by $280 million savings by waste reduction and technological improvements to the state Medicaid program.
Source: thecoloradoobserver.com

Income Thresholds For Medicare Part B And Part D Premiums

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Moneycation: Medicare Part D: Plans and price comparison

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You are likely to find several plans offered to you from several private insurance companies that seem to meet your needs. By using Medicare.gov’s Medicare Plan Finder before you make a change, you will be able to see which plans provide coverage for your state and town. You will see which are likely to have a low cost when the monthly premium, deductible and copayments are all considered. By contacting the various company’s websites or agents you can learn what is required of you in regards to using their network. Following these steps should make it easier for you to select the right prescription drug plan for you needs.
Source: moneycation.com

Video: Compare 2013 Medicare Advantage Plans – Tips

Medicare Benefits and Cost

This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

Medicare Part D 2010 Data Spotlight: A Comparison of PDPs Offering Basic and Enhanced Benefits

Companies that sponsor Medicare Part D prescription drug plans are required to offer a basic benefit, either the standard Part D benefit defined by law or an actuarially equivalent benefit design. Plan sponsors can also offer plans with enhanced drug benefits. Enhanced plans are required to have a greater actuarial value than basic plans, but plans vary in the ways in which they improve coverage.
Source: kff.org

Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

Many of the budget proposals and debt-reduction plans being considered by Congress and the Administration include proposals that would achieve substantial savings from the Medicare program over time. This brief features a side-by-side comparison of the key Medicare provisions in three major budget and debt-reduction plans:
Source: kff.org

Research Roundup: Comparing Medicare Budget Plans

JAMA Pediatrics: Nurse Staffing And NICU Infection Rates –Neonatal intensive care units (NICU) – which provide care for infants who are critically ill – are costly and require a significant amount of nursing services. Little is known, however, about the adequacy of nurse staffing at these units. Using data from 2008 and 2009, researchers analyzed the relationship between adherence to national staffing guidelines and hospitals-associated infections among very low birth-weight (VLBW) infants. “Our results document widespread understaffing relative to guidelines: one-third of NICU infants were understaffed… ,” the authors write. “In VLBW infants, NICU nurse understaffing relative to guidelines was associated with a sizable increase in infection risk.” They conclude that their findings “suggest that the most vulnerable hospitalized patients, unstable newborns require complex critical care, do not received recommended levels of nursing care. Even in some of the nation’s best NICUs, nurse staffing does not match guidelines” (Rogowski et al., 3/18).
Source: kaiserhealthnews.org

WellCare Medicare Enrollment Online

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Crowe and associates High Deductible F supplement how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare Advantage Medicare Advantage plans medicare b Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare part B Medicare part B cost Medicare part D Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 Original Medicare united healthcare United Healthcare AARP United medicare complete United Medicare complete 2013
Source: croweandassociates.com

weight loss: The Coverage For Arizona Medicare Recipients Can Be Very Confusing

The exact type of coverage that is included in their Medicare policy can often be challenging for AZ Medicare recipients to understand. In some instances the patients experience a gap of coverage or limited coverage that requires them to pay those expenses out-of-pocket. With the increasing cost of health care these days, it can get to be quite expensive for Medicare recipients, especially those living on a tight budget. Medicare coverage often only partially covers some medical services, which need supplemental types of insurance plans to help fill in those gaps that are left by traditional coverage from Medicare. Medicare coverage can contain several different parts called Part A, Part B, Part C and Part D that you need to understand. In order to be eligible to obtain Medigap insurance plans an individual must have traditional Medicare Part A and Medicare Part B coverage. If an individual also has Medicare Part C coverage they do not need to buy Medicare Supplement Insurance. Medicare Supplemental Insurance plans are available in twelve standardized service plans for Arizona Medicare recipients. Policies like this are available through providers and permit you to compare the costs as well as conduct a policy comparison. A comprehensive set of services are included through the Medigap plans that use A through L labels. Remember that the providers of these supplemental policies are not required to limit the cost of premiums or offer a complete line of all the policy plans. In order to obtain the correct level of coverage that you need and will fit your budget you should cautiously perform a comparison. It is imperative to note that Arizona Medicare supplement policies cover just one individual. A Medicare supplement Arizona providers can offer is needed for each individual if a participant is eligible for coverage through their spouse, as an example. An experienced professional who understands the supplemental coverage is the best person to help you comprehend this better and make the right choices with a consultation. The final type of coverage we will address here is the Arizona Medicare Advantage Policies. These plans are often referred to as MA plans, or Medicare Part C coverage. The Medicare Advantage Arizona seniors elect as a plan provides all Medicare benefits that Part B and Part D offer through the Medicare Advantage Provider that they have selected to work with. Careful consideration should be given to the many types of plans that are available including many more details that are involved..
Source: blogspot.com

What to Look for When Comparing Medicare Part D Costs

Information presented on Personal Finance Blog by MoneyNing is intended for informational purposes only and should not be mistaken for financial advice. While all attempts are made to present accurate information, it may not be appropriate for your specific circumstances. Any offers and rates shown on this site can change without notice and may contain information that is no longer valid. For further validation, always visit the official site for the most up-to-date information. This site may receive compensation from companies to offer an opinion about a product or service. We strive to provide honest opinions and findings, but the information is based on individual circumstances and your specific experiences may vary. We also treat your privacy seriously. Please take some time to understand our full policies and disclaimers by clicking here.
Source: moneyning.com

Medicare Part D is prescription drug coverage insurance that is provided by private companies approved by Medicare.

Example: Mrs. Smith didn’t join when she was first eligible-by June 15, 2009. She doesn’t have prescription drug coverage from any other source. She joined a Medicare drug plan with an effective date of January 1, 2012. Her drug coverage was effective January 1, 2010. Since Mrs. Smith was without creditable prescription drug coverage from July 2009-December 2011, her penalty in 2011 was 30% (1% for each of the 32 months) of $31.08 (the national base beneficiary premium for 2012), which is $9.32. The monthly penalty is rounded to the nearest $.10. She pays this late enrollment penalty of $9.30 monthly in addition to her plan’s monthly premium. Here’s the math: .30 (30% penalty) x $31.08 (2012 base beneficiary premium) = $9.32 $9.32 (rounded to the nearest $0.10) = $9.30 $9.30 = Mrs. Smith’s monthly late enrollment penalty
Source: medicare.gov

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

Here’s how plans for retirement used to go for most – work at the same job for several decades, build up social security and pension income, retire at 65 and dedicate time to improving canasta or golf skills. Maybe some people had other ideas, but suffice it to say, people view retirement much differently today than they did 20 years ago. Retired firefighter, Steven Pewter is a perfect example of this. At age 74, with absolutely no technology background, Pewter used a laptop computer he got as a birthday present to build a website for seniors to compare Medicare supplemental insurance plans, MedicareSupplementalInsuranceComparison.net. Pewter’s story supports the findings of a new survey from Del Webb – a leading builder of active-adult communities. It showed that almost 80 percent of boomers expect to work in some capacity, even after they retire, and not just for money. In fact, the majority, fifty-one percent, plan to work to avoid boredom and maintain a sense of purpose. “I come from working stock,” commented Pewter when asked about his motivation. “I certainly wasn’t going to just sit around and slowly fade to dust after retirement.” Pewter was driven to create the Medicare supplemental insurance comparison site after a frustrating personal experience shopping for supplemental coverage online. Hours and hours of research turned up only sites that required significant personal information before returning any valuable information on plans or rates. So, he decided to use his new computer skills to create a site that would give people detailed supplemental insurance coverage and rate information after entering just their zip code. The site gained almost instant popularity with 10,000 visits in the first week. By the end of the first month, 30,000 people had used the site to research Medicare supplemental insurance. And now nearly seven months later, the site continues to attract seniors, not just with its rate and plan comparison info, but with the dozens of articles, tutorials and how-to pieces it features that are updated regularly. Pewter’s family members comment that he has approached his new Internet endeavor with the gusto and enthusiasm of a man a third his age. “Well, it’s my kids and grandkids that keep me young,” Pewter said. “Knowing they’re so proud of what I accomplished with the site pushes me to keep at it.” About MedicareSupplementalInsuranceComparison.net MedicareSupplementalInsuranceComparison.net is a site for seniors to compare rate plan and coverage information for Medicare supplemental insurance. By entering just a zip code, visitors can retrieve detailed results from leading insurance providers in their area. And, the site is constantly updated with helpful articles and tutorials to guide people through the sometimes confusing world of Medicare. For more information, visit: http://www.medicaresupplementalinsurancecomparison.net
Source: sbwire.com

Medicare Advantage Plans have Fewer Cardiovascular Procedures: Study

The study showed that there were 36% fewer angiographies and 30% fewer percutaneous coronary intervention procedures for Capitated Medicare Advantage patients in comparison to those enrolled in traditional Medicare fee-for-service plans after adjusting for age, sex, race, and income. Daniel Matlock, MD, MPH, of the University of Colorado Denver, and colleagues revealed the figures.
Source: topnews.ae

Compare Medicare Advantage Plans

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Sightings Over Sixty: I Apply for Medicare, Part II

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Free Condoms & Lollipops

Posted by:  :  Category: Medicare

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abortion birth control Bootcamp breastfeeding cancer Cardio celebrity chronic disease diet domestic violence entertainment education Exercise fast food Fat FC&L Updates Fitness flu health campaigns healthcare reform healthwatch healthy eating heartbreak HIV/AIDS media images mental health natural hair News nutrition obama obesity Oprah pregnancy relationships research RIP sex smart shopping stereotypes stigma vaccines vegetariran weight Loss weight management Wrap-it-up youth and health
Source: freecondomsandlollipops.com

Video: FREE MEDICARE LEADS/ MEDICARE SUPPLEMENT LEADS/ INSURANCE SALES LEADS

May 29, 2013 Conference Call

cigna closing CMS CMS data conference call dental e-app electronic application equitable equitable life final expense final expense by phone foresters gerber life guaranteed issue Guaranteed Issue Life guarantee issue hearing Heartland National Hospital Indemnity Interview life insurance medicare advantage medicare supplements medico Missouri mutual of omaha New Era New Era Life objections orlando event phoenix life Plan F Plan F vs. Plan G Plan G planright predictive dialer radius bob sell medicare by phone sell medicare supplements by phone stonebridge training vision webinar where to market
Source: medicareagenttraining.com

FREE Webinar for Medicare Advantage Providers: How to Boost Online Enrollments

  You are not alone in dealing with this problem. We invite you and the members of your marketing team to join your colleagues for a FREE 55-miniute webinar to be hosted by two of our DMN3 online marketing experts. We’ll discuss ways to better reach your audience through online marketing. 
Source: dmn3.com

Why does Slate’s Matt Yglesias keep publishing the private information of Daily Caller reporters?

The indispensable crew at Ydiot note that earlier today, Matthew Yglesias posted the phone number of Daily Caller reporter Jonathan Strong on his popular blog. He obtained the phone number through private correspondence with Strong, and cut and pasted the following conversation:
Source: dailycaller.com

Medicare Inpatient vs. Outpatient Under Observation and Hospital Costs

Her family only learned about the problem the day Arnau left the hospital, says her daughter Mimi Auer, who is considering appealing the decision. At first she thought it was a mistake. But staff at the nursing facility told her they’d had four cases like her mother’s just the previous week. "Four cases of the same situation, [in which Medicare patients] had to pay for the nursing home because they’d been on observation in the hospital," Auer protests. "What’s going on here?"
Source: aarp.org

Twitter immediate Zimmerman responses

George Zimmerman, right, is congratulated by his defense team after being found not guilty during Zimmerman’s trial in Seminole circuit court in Sanford, Fla. on Saturday, July 13, 2013. Jurors found Zimmerman not guilty of second-degree murder in the fatal shooting of 17-year-old Martin in Sanford, Fla. The six-member, all-woman jury deliberated for more than 15 hours over two days before reaching their decision Saturday night. (AP Photo/Gary W. Green, Pool)
Source: dailycaller.com

What Incontinence Products To Buy

Posted by:  :  Category: Medicare

Incontinence issues are common all around the globe as reported by Medicare and Medicaid. A customer with changing bowel and bladder habits may start to browse for guides, monitors, gloves, cream, pads, underwear guards, briefs, and liners to prevent leakage and loss of dignity. Solutions and medications can be found on WebMD and http://incontinencebegone.com/valuable-facts-you-must-know-about-incontinence/. These tools are all non-returnable says Kmart. Testimonials about the products are available. Free screening and diagnosis for bladder accidents is available in different clinics. A catalog for penis and vaginal cleaners can be found on the internet for further study. Fitted liners for a mattress are under this category. Physician should be consulted for evaluation.
Source: ydachicago2009.com

Video: Urinary Catheter Supplier & Urological Supplies – Medicare and Private Insurances Accepted.

Incontinence Products And Personal Hygiene : TheShakyHands.net

Incontinence is one of the problems elderly people face today. Incontinence products like undergarments, briefs, diapers, washcloths, wipes and other accessories work with people who have incontinence. These products provide tranquility and comfort to people during bedtime. Most of these products are reusable. Information about these brands can be found at http://incontinencebegone.com/valuable-facts-you-must-know-about-incontinence/. Medicare has taken note of these products and devices to cover their applicants. The good thing about these products is that anyone can purchase it without a prescription. People can browse online and send an email to a particular website to order these products. These products are both available for pediatric and geriatrics. Pet peeves for people with incontinence are products with scales.
Source: theshakyhands.net

The Reason Why Are Underpads The Most Commonly Used Incontinence Products

Incontinence is one of the problems elderly people face today. Incontinence products like undergarments, briefs, diapers, washcloths, wipes and other accessories work with people who have incontinence. These products provide tranquility and comfort to people during bedtime. Most of these products are reusable. Information about these brands can be found at http://incontinencebegone.com/valuable-facts-you-must-know-about-incontinence/. Medicare has taken note of these products and devices to cover their applicants. The good thing about these products is that anyone can purchase it without a prescription. People can browse online and send an email to a particular website to order these products. These products are both available for pediatric and geriatrics. Pet peeves for people with incontinence are products with scales.
Source: moveon.info

Medicare Incontinence Supplies

Urinary incontinence and unexpected bowel problems are no longer whispered about subjects among medical professionals, patients and caregivers. However, these conditions are still private matters for many people. Increasing life span averages and progressive medical advances allow patients to use simple solutions such as Diapers for Adults, disposable garments such as Depends Adults Diapers and Adult Cloth Diaper products rather than complicated, expensive and embarrassing waste bags and catheter tubing. The demand for convenience, and the increased medical necessity for these products has dramatically increased the market for privately purchased disposable protection and billed Medicare incontinence supplies requested by hospitals, nursing homes and assisted living facilities. Individual consumers and facility purchasing managers will not only find product use to be easier, but purchase and delivery methods are streamlined when buying online.
Source: forincontinence.com

Incontinence Products And Personal Hygiene

Of all the incontinence products available, how are we supposed to know which one is the best protective one? If you are suffering from urinary incontinence, consulting your health care provider will lead you to some medication tips or surgical procedures. But then the next concern is: will your Medicare pay for all your incontinence supplies like your diapers, underwear liners, supplements, healthcare items? As for the products, light pads, protective underwear, adult diapers, bed pads and even skin care items can provide aids and tranquility to incontinence sufferers. But at the end of the day, choosing the best items is still your decision.
Source: happyhareonline.com

What Incontinence Products To Buy

Incontinence is one of the problems elderly people face today. Incontinence products like undergarments, briefs, diapers, washcloths, wipes and other accessories work with people who have incontinence. These products provide tranquility and comfort to people during bedtime. Most of these products are reusable. Information about these brands can be found at http://incontinencebegone.com/valuable-facts-you-must-know-about-incontinence/. Medicare has taken note of these products and devices to cover their applicants. The good thing about these products is that anyone can purchase it without a prescription. People can browse online and send an email to a particular website to order these products. These products are both available for pediatric and geriatrics. Pet peeves for people with incontinence are products with scales.
Source: bigkult.com

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Competitive Bidding In Medicare: A Response To The Bipartisan Policy Center’s Proposal

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