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Medicare's Measure for Readmissions Fails to Identify Excellence and Improvement
San Diego County is doing much better than the national average at reducing readmissions to hospitals, yet nearly all their eligible hospitals are being penalized by Medicare's hospital readmissions penalty program.
Altarum Institute’s Center for Elder Care and Advanced Illness today released data showing that San Diego County is doing much better than the national average at reducing readmissions to hospitals, yet nearly all their eligible hospitals are being penalized by Medicare’s hospital readmissions penalty program.
The problem is that Medicare measures progress by dividing the number of readmissions by the number of discharges from each hospital; it turns out that good practices reduce the discharges at nearly the same rate as readmissions, making the ratio stay the same despite substantial improvement.
Read more: http://bit.ly/1zRagMc
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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