Medicare business news on MA, PDP and related topics


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“We are a better and stronger company as a result of collaborating with CMS and investing further in our processes and technology over the past 18 months,”
-Shawn Morris, Interim President, Cigna-HealthSpring


A study from the Alliance for Physical Therapy Quality and Innovation (APTQI) examined different initial interventions and their associated costs for low back pain, within the Medicare program. According to the study, Medicare costs for back pain patients who received physical therapy as their first intervention were 19% less those who initially received injections, and approximately 75% less than those who received surgery first. In addition, patients who opted for physical therapy within 15 days of being diagnosed of back pain saw 27% lower average costs due to fewer required follow-on health care services such as injections and surgeries, according to the study.

Source: APTQI

Medicare Video
Risk Adjustment Round Up Reviewing the CMS Call Letter and Other Trends  

Risk Adjustment Round Up Reviewing the CMS Call Letter and Other Trends

SCIO hosted a special webinar focused on CMS’ CY 2018 Call Letter and other risk adjustment trends affecting Medicare Advantage health plans and provider groups.

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CMS: 1991-2014 Health Care Spending by State, 6 Key Findings

1. Considerable regional variation on personal health care spending
2. Similar growth in Medicaid expansion and non-expansion states
3. Click to continue

 Source: CMS

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2017 Predictive Modeling Web Summit, June 23, 2017
MACRA Webinar: Lessons Learned from the 1st Round PTAC APM Recommendations, June 26, 2017
Access Transformation Techniques for Medical Groups & Healthcare Systems, June 27, 2017
Hospital Network Formation – A Growing Alternative to Mergers, June 29, 2017
Check, and Check, & Triple Check! The Discipline of Member Identity Intelligence, July 19, 2017
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