In The News

MedPAC Explores Standardized Plan Options in Medicare Advantage

Fierce Healthcare | By Robert King
 
Affordable Care Act (ACA) plans may not be the only ones to introduce standardized options, as a key advisory panel wants to apply a similar strategy to the popular Medicare Advantage (MA) program. 
 
The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare issues, is researching how standardized benefit options would work for MA. The goal is to include the findings in an annual report to Congress next year and explore how standardization could help simplify choice for seniors. 
 
“I think there’s some reasonable evidence about the challenges of choice,” said Michael Chernew, the commission chair, during the panel’s Thursday meeting.
 
MA plans are required to offer services under Medicare Parts A and B, but there are some differences based on cost-sharing and other supplemental benefit packages. The MA program has gained in popularity in recent years and with it an abundance of plan choices for seniors.
 
Commission staff gave an example of how standardized benefit packages work by breaking out three options based on how generous they were for cost-sharing. What types of plans would be subject to the standard package would have to be decided and could be vital.
 
“This requirement would aim to ensure a minimum level of access to standardized plans, but its impact could be limited if the plans that insurers are required to offer are unpopular,” said MedPAC staff member Eric Rollins.
 
Letting insurers offer both nonstandardized and the standard options could also help reduce any disruption for existing enrollees but could reduce any gains from standardization, he added. Only offering the standardized benefit plans, on the other hand, could cause too much disruption.
 
There could be a benefit to insurers, though, by avoiding paying a broker that guides seniors through different plan options. 
 
“There’s a huge financial incentive for them,” said commission member Lynn Barr.
 
However, some commission members were concerned about the impact standardization could have on plan innovation. 

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Effects of Exposure to Death and Dying on Belief Systems Survey

Researchers within the Psychology Department at the Metropolitan University Manchester (MMU) invite you to participate in an online survey to investigate the Effects of Exposure to Death and Dying on Belief Systems. Specifically, this study will develop a new measure of exploring levels of exposure to death and examining how that exposure affects individuals’ belief systems and outlook on death. 

  • The study takes the form of a survey (self-report measures) and requires respondents to complete questions/statements.
  • The study takes approximately 30 minutes to complete. 
  • To participate you must be 18 years of age.

Further details provided by clicking on the study link 

https://mmu.eu.qualtrics.com/jfe/form/SV_a3gOsAqGZMsxWCi
 

U.S. FDA Green Lights Omicron-Targeted COVID Boosters Ahead of Revaccination Campaign

Reuters | By Michael Erman and Julie Steenhuysen

Aug 31 (Reuters) - The U.S. Food and Drug Administration on Wednesday authorized updated COVID-19 booster shots from Pfizer (PFE.N)/BioNTech (22UAy.DE) and Moderna that target the dominant BA.4 and BA.5 Omicron subvariants, as the government prepares for a broad fall vaccination campaign that could begin within days.

The new vaccines also include the original version of the virus targeted by all the previous COVID shots.

The FDA authorized the shots for everyone ages 12 and older who has had a primary vaccination series and is at least two months out from a previous booster shot, shorter than prior recommended intervals.

Dr. Peter Marks, a senior FDA official overseeing vaccines, said he hopes the shots will restore the very good protection against symptomatic disease that the original vaccines offered when launched in late 2020 and early 2021.

"We don't know for a fact yet whether we will get to that same level, but that is the goal here," Marks said.

The government has begun working on the fall rollout, which could start soon after the U.S. Centers for Disease Control and Prevention's (CDC) outside expert panel meets on Thursday and agency Director Rochelle Walensky makes a final recommendation.

The United States has secured more than 170 million doses of the two shots in an attempt to stave off the worst effects of a potential surge in infections as schools reconvene and people spend more time indoors due to colder weather.

This could be the last COVID vaccine provided for free to all Americans as the government plans to shift them to the commercial insurance market next year. read more

Moderna's retooled vaccine was authorized for those aged 18 and above, while the Pfizer/BioNTech shot will be available for those aged 12 and above, the FDA said.

Pfizer said it has some doses ready to ship immediately and can deliver up to 15 million doses by Sept 9. Moderna said it expects its new shot to be available "in the coming days."

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CMS Home Health Proposed Rule Impact White Paper

The attached one-pager was prepared by the Partnership for Medicaid Home-Based Care to illustrate the impact of the proposed CMS cuts on home health and those you serve. 

Please download the attached Colorado One-Pager and distribute widely to Senators, Congressmen & the media.
 

CMS Care Compare August 2022 Data Refresh

From NHPCO

[August 31, 2022], publicly reported hospice quality data was refreshed on the CMS website Care Compare. The following measures are posted:

  • Hospice CAHPS® Star Ratings for all hospices with 75 or more completed CAHPS surveys over the eight-quarter reporting period.
  • Hospice Care Index (HCI) which captures data from ten individual indicators and is presented as a single claims-based measure.
  • Hospice Visits in the Last Days of Life (HVLDL) which measures the proportion of hospice patients who received in-person visits from a registered nurse or a medical social worker on at least two of the final three days of life.
  • Hospice Item Set (HIS) Comprehensive Assessment Measure at Admission which captures, in one measure, the proportion of patients for whom the hospice performed seven care processes upon admission to hospice.
 
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