Wakely Wire
New Insights
Whitepapers, briefs, press releases and more
Oops, Let’s Do It Again: CMS Announces Sweeping Changes to 2025 Quality Bonus Payments
On June 14, 2024, the Center for Medicare and Medicaid Services (CMS) announced that they will recalculate the 2024 Star Ratings for the purpose of determining 2025 Quality Bonus Payments (QBPs), following recent court rulings in favor of SCAN Health Plan and Elevance Health, Inc. As a consequence of this decision, many Medicare Advantage (MA) ... Read more
Week in Washington 06/27/24
Campaign KFF created a good comparison of the two Presidential Health Care records and positions. There is a stark contrast between the candidates on a number of issues and KFF has a good summary of them. Congress Politico reports that several health care bills are potentially getting committee votes in the House. Under consideration is ... Read more
Events & More
Unlocking Solutions in Medicaid, Medicare, and Marketplace
HMA Fall Conference • October 7–9
Pre-Conference: October 7 • Marriott Marquis Chicago
Recent decisions by CMS regarding Medicare Advantage (MA) plan Star Ratings will profoundly influence the MA market now and in the coming years. At HMA’s Fall Conference, expert-led sessions will delve into the evolving issues shaping MA as well as traditional Medicare landscapes.
As CMS intensifies its data collection efforts and puts downward pressure on MA rates, attendees will hear from health plan executives about impacts on plan bids and strategic directions. Discussions will also focus on:
- Refining incentives to supplemental benefits to improved competitive positioning
- Critical decision points driven by Medicare’s regulatory frameworks
- Opportunities to drive improvements in integrated services and supports
- Innovative approaches to reduce cost and improve quality outcomes
- How health equity affects quality ratings
Newsworthy Findings
Appeals Court Upholds ACA’s Preventive Services Mandate, but Opens Door to Future Challenges
The Fifth Circuit Court of Appeals’ decision Friday is a win for the upwards of 150 million people that receive health insurance through their employers.
HHS Finalizes Info Blocking Penalties for Providers
Providers pushed back against the disincentives, with the Medical Group Management Association calling them “unnecessarily punitive.”
Wyden blasts Express Scripts' pricing tactics, asks CMS to intervene
Senate Finance Committee Chair Ron Wyden urges CMS to enforce Medicare Part D requirements for PBMs to protect small pharmacies and ensure fair reimbursements.
Where UnitedHealthcare is seeing cost savings in its Surest plan
UnitedHealthcare's Surest health plan, previously known as Bind, has demonstrated significant cost savings and improved utilization, with an Aon study showing over $400 in claims cost savings per member per year by eliminating deductibles and providing upfront pricing information.
PatchRx to integrate medication adherence data with virtual care platforms
Remote therapeutic monitoring company PatchRx can now integrate its medication adherence insights into existing care management platforms through PatchRx Connect.
Bonus Article
Boy Who Got Free Life-Changing Leg Surgery Returns to Same Hospital Ship a Decade on–Wanting to Be a Doctor
Just for Fun
Math Riddle:
How are a dollar and the moon similar?
Prior Week
Q: What number has the same number of letters as its value?
A: Four
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