Part D admin costs 11% of total drug spend
Medicare & Reimbursement Advisor Weekly, August 26, 2009
Private Medicare Part D plans average 11.3% in administrative costs as a share of total drug spending, according to a recent Commonwealth Fund study. Private health plans’ administrative costs averaged 9% of premiums across all policies sold and are well below “vastly overstated” estimates offered by proponents of a government-run public plan, the Blue Cross Blue Shield (BCBS)-funded study found. Here’s the link: http://healthplans.hcpro.com/content/237493/topic/WS_HLM2_HEP/BCBS-Study-Shows-Low-Health-Plan-Administrative-Costs.html
North Carolina may mandate new preadmission screen
North Carolina may mandate a uniform screening program for Medicaid patients before they are admitted to skilled nursing facilities. Information on the PreAdmission Screening and Annual Resident Review tool can be found at www.ncmust.com/.
Against medical advice
A report that 39% more patients left their hospital beds against medical advice in 2007 compared with 10 years earlier caught one of the nation’s leading hospital quality experts off guard.
To read the full story, click on: http:// healthleadersmedia.com/content/237775/ topic/WS_HLM2_QUA/Many-Hospitalized-Patients-Leave-Facilities-Against-Medical-Advice.html
Oregon embraces more holistic reimbursement system
The state’s Health Policy & Research meeting will be September 23. At its most recent meeting in July, the committee discussed the Four Quadrant Clinical Integration Model as a framework for assessing and treating patients with different levels of healthcare needs. The group also recommended a reimbursement framework that rewarded holistic care. The rationale: The current fee-for-service payment structure can be a hindrance for providers to use effective interventions. In the literature, this system is often cited as placing financial incentives behind medical overutilization and resource inefficiency by putting the full risk of care on the payer. Policies which further exacerbate this trend include the undervaluation of preventive services, as well as the overvaluation of non-preventive services; non-payment to physicians for services required to provide patient-focused, care coordination; and the provision of incentives for volume of services without regard to quality of care or resource utilization. Read details at: http://www.oregon.gov/OHPPR/MAC/docs/Meeting_Materials/2009_Materials/MAC_Meeting_Materials_072209.pdf
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- What does case-mix index mean to you?
- Note similarities and differences between HCPCS, CPT® codes
- Q&A: Primary, principal, and secondary diagnoses
- Practice the six rights of medication administration
- Complications from immobility by body system
- Nursing responsibilities for managing pain
- Prevent dehydration with nursing interventions
- OB services: Coding inside and outside of the package
- Know the medical gas cylinder storage requirements
- E-mailed
-
- Will the JCAHO consider my facility's use of side rails a restraint?
- Understand the spine to code back procedures correctly
- Strive to bill all payers the same
- Coding Clinic reiterates guidelines for provider documentation
- CMS final rule clarifies that medical staff can extend beyond physicians
- Catch up on what's new with injections and infusions
- Capturing start and stop times for infusions
- Searched
-
- trauma informed care
- Delegation of decision making by board
- 13719
- can an LPN do home health aide supervision
- Changes to therapy reporting and reimbursement tha
- dnv standards compliance manual
- practice exam
- study recounting the cost of CAUTIs
- Burroughs J. 402011 Dec. 2941. Your hospitals fina
- Case management boot camp
