The Centers for Medicare and Medicaid Services (CMS) released its 2017 Advance Notice and Draft Call Letter which includes a number of provisions designed to help plans that enroll large numbers of dually eligible beneficiaries. The proposed rates reflect the CMS announcement late in 2015 that it has historically underpaid plans that serve large numbers of dual eligibles, and the proposal creates several new subcategories for this high-need, high-cost population. In addition, the proposal makes changes to the quality ratings system, adjusting some quality measures to account for the socioeconomic characteristics of a plan’s enrollees. Comments to the proposal are due March 4, 2016 in preparation for final release on April 4.
The Centers for Medicare and Medicaid Services (CMS) and leaders of the trade group America’s Health Insurance Plans announced that they have reached consensus on how to measure physician quality in seven core measure sets. This agreement represents the first time that CMS and the health insurance industry have agreed on a way to measure how well doctors perform in their jobs. The agreement is expected to have a long-term impact on how both Medicare and private health plans pay doctors. The agreement is also designed to lessen the paperwork burdens on physicians and provide consumers with a way to compare physician quality.
The Dartmouth Atlas Project has released Our Parents, Ourselves: Health Care for An Aging Population. This report, funded by The John A. Hartford Foundation, takes a person-centered view of health care and includes geographically specific data that demonstrates regional disparities in the health care experience of older adults. The report looks at geographic disparities for a variety of measures, including the number of days per year the average Medicare beneficiary is in contact with the health care system, hospital readmission rates, the provision of certain screening tests not recommended for adults over age 75, length of time before referral to hospice care and prescribing of high-risk medications.