May 9, 2024

Below are the Contents of our current ABL Healthcare Online News & Trendletter

Click on Specific Headlines to Read Specific Articles

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Medicare Advantage on the 50 Yard Line

BLOG by by David Saÿen, former Regional Administrator at CMS, the Centers for Medicare and Medicaid Services, and currently the President of the Board of Trustees at the Alameda Health System

Recently, former Louisiana governor, Bobby Jindal, published an opinion piece in The Wall Street Journal titled “Biden Sabotages Medicare Advantage.” With the program nearing 50% penetration, he frets about the annual payment adjustment being too stingy. Just a few days later the same paper trumpeted, “Health Giant’s Earnings Lift Stocks for Sector.” Despite the fiasco caused by the hack of Change Healthcare, a UnitedHealth Group company, revenue climbed 8.6%, beating analysts’ estimates. Apparently shoddy work by health insurers isn’t a problem like it is for airplane manufacturers.

Medicare Advantage is a private program where the federal government pays an age- and health-adjusted premium for beneficiaries opting for private plans. It is lauded by conservatives as beneficial for consumers. It’s sort of like vouchers for public schools, block grants for Medicaid, and cutting Social Security. Always in fashion for some. While it may benefit investors and health insurance companies, it’s not always advantageous for all seniors and disabled folks in Medicare.

Medicare has a punishing calendar for the folks at CMS. Every year there are changes, and there is an annual rule updating payment for each program area: hospitals, physicians, and health plans in particular. Jindal’s concerns stem from changes outlined in the April 4, 2024, MA rule. The complexities of Medicare payment are beyond the scope of this blog, but the upshot is that the rule trims the base payment by 0.16%, the program changes overall are expected to yield a 3.7% increase in payments to plan. These changes aim to improve access to behavioral health providers, enhance transparency regarding supplemental benefits, introduce standards for special supplemental benefits for chronically ill individuals, and refine star ratings for plan evaluations. Additionally, there’s a focus on ensuring equitable utilization management practices, emphasizing health equity expertise.

Despite Jindal’s apprehensions about payment updates, the regulatory changes seem positive overall. While some plans may exit certain markets, as is common, Medicare Advantage appears set for another successful year.

David Saÿen is the former Regional Administrator at CMS, the Centers for Medicare and Medicaid Services,
and is currently the President of the Board of Trustees at the Alameda Health System

HEALTHCARE MEMBER NEWS

WELCOME NEW MEMBER!

Vinit Joshi Vinit Joshi, DDS, is CEO of Global Implant Dentistry (GID), which is dedicated to providing expert family implant dentistry services that enhance oral health, brighten smiles, and boost confidence. GID’s expert team works with precision and care to place just four implants – the cutting-edge All-On-4 dental implant technique – which is an advanced and much faster process. Having developed unique skills, techniques, and processes in implant dentistry, Vinit is also actively involved in training other medical professionals in his innovative surgical techniques, including the digital integration of surgery, utilizing CT scans and 3D milling and printing technologies.

As Vinit and his team train more dentists in their state-of-the-art approach, he aims to expand GID, in a hub-and-spoke fashion, with Global delivering their unique products that will enable the dentists and other medical professionals to get the best results for their clients as they use their All-On-4 and other specialized implant services. Additionally, Vinit has worked with the UCLA craniofacial team and used his expertise to aid sleep apnea and TMJ patients by improving airway space. Vinit has joined the LA Healthcare Round Table.

UPCOMING ABL HEALTHCARE ROUND TABLES

  • 5/01 – Orange County ZOOM Table“How Change Healthcare Could Change Healthcare” – Featuring Sara Shanti, Partner at Sheppard Mullin

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  • 5/16 – Bay Area ZOOM Table“Welcome Habitat Health: California’s Newest PACE Program” – Featuring Simon Widdowson, Senior Director of Business Development for Kaiser Permanente

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  • 5/17 – Los Angeles ZOOM Table“Praia Health: Bringing Digital Transformation to the Healthcare Marketplace” – Featuring Marcee Chmait, Head of Digital Partnerships & Business Development at Providence Digital Innovations Group

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BLOG by Mimi Grant, President of ABL Organization

IT’S BACK TO THE FUTURES OF HEALTHCARE

FUTURES Exhibit

Mimi recently participated in the “Living Longer Festival: Health + Wellness 2050,” held at the Smithsonian Arts & Industries Building on the National Mall. Here, Mimi shares a brief photo journal, with captions, of her incredible experience.

National Museum
In 1879, the “National Museum” – the nation’s first, was “crowned” on the Washington Mall. Last November, after being closed for the past 20 years, the renamed Smithsonian “Arts + Industries Building” (AIB) reopened its doors to host the “FUTURES” exhibit. Over the eight months of the exhibit, FUTURES looked at a number of themes, including the future of AI, Generative Design, Conservation, Energy, Transportation, Work, Fashion, Gaming, and “Healthcare – in 2050.”

The Doctor is In (Space)
On June 25th, the “Living Longer Festival: Health + Wellness 2050,” highlighted a special demonstration entitled, “The Doctor Is In (SPACE),” “demonstrating” how an astronaut using a MedWand on a patient in space could conceivably link with a terrestrial doctor for an exam. MedWand’s Co-Founders, Bob Rose, CEO, and Samir Qamar, MD, CMO, were frequently seen on-hand answering questions from the 12,000 visitors who toured the Exhibit on “Solstice Saturday,” when several of the Smithsonian museums, including AIB, stayed open late – some till midnight.

Living Longer Festival
Later, I had the honor of moderating an outstanding panel of experts, supplemented with questions from the audience who “Interrupted Your Regularly Scheduled Panel” throughout “WIYRSP: Living Longer in the Future.” To kick it off we introduced “Elizabeth,” a great grandmother, who was captured on her grandson’s iPhone for the masses when she demonstrated her impressive moves as she got down to Bruno Mars at her 100th birthday party surrounded by friends and family…

CLICK HERE TO READ THE REST OF MIMI’S BLOG WITH MORE, LARGER PHOTOS

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