Notice to Medicare observation patients misses the mark

If you’re one of the roughly 2 million Medicare beneficiaries placed under observation each year, there’s (potentially) good news for you: You may be less vulnerable to sticker shock when you get your medical bill. But Medicare hasn’t gotten the details right just yet. In less than two months, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act will require hospitals nationwide to notify Medicare observation patients that they are not formally admitted as inpatients and why. …

Diabetes Prevention Program Shows Investing in Prevention Pays

Diabetes among older adults is associated with significant health and cost burdens. Nearly a quarter of individuals age 65 and older have been diagnosed with diabetes, and one of every three Medicare dollars is spent on beneficiaries living with the condition. An estimated one-half of the Medicare population is prediabetic, meaning their blood sugar levels are high but not high enough to warrant a diabetes diagnosis. To address this growing public health concern, in 2011 the Centers for Medicare & …

Building Capacity to Provide Behavioral Health Services to Dual Eligibles

The Centers for Medicare & Medicaid Services (CMS) launched the Financial Alignment Initiative (the Initiative) to improve the quality of care received by low-income adults who are eligible for Medicare and Medicaid — known as dual eligibles. Many of these individuals have unmet behavioral health needs, ranging from mild depression to serious mental illness, like schizophrenia and bipolar disorder. A recent update on the Initiative presented to the Medicare Payment Advisory Commission highlighted four challenges to providing behavioral health services …

Shingles Vaccine May Be out of Reach for Some Medicare Beneficiaries

Introduction to Shingles Shingles is a viral infection that causes a painful skin rash. It is caused by the varicella-zoster virus — the same virus that causes chicken pox. Once people recover from chicken pox, the virus remains in their body in an inactive state. In some people, it stays dormant; in others, the virus reactivates and causes shingles. The condition is most common in older adults and people with weakened immune systems. The most common complication of shingles is …

Medicare and Private Health Plans Agree to Common Standards to Evaluate Doctors: Why This Is Good News for Consumers

For over a year, a multi-stakeholder group composed of Medicare administrators, doctors, private health plan representatives, consumer groups and employers has worked together to figure out a uniform way to rate doctors’ performance. Today, the group announced agreement on a core set of quality measures that Medicare and private health insurance plans will phase in to evaluate doctors. Medicare and many private plans are transitioning to a new way to pay doctors: paying them based on the quality of their work, rather than …

7 Legislative Happenings for Older Americans

With 2015 behind us, it’s the season of “best of 2015” and “bold predictions for 2016” lists. Consider this a hybrid. Looking back, there were seven important happenings and victories for older Americans and their families in 2015. They happened in Washington, D.C., state legislatures and communities across the country and will help improve the lives of millions of people. In some cases, we solved long-standing challenges, including protecting seniors’ access to their doctors. In other areas, like supporting family …