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Category Archives: Medicare

Legislative History of Health Rewards – We’ve Come a Long Way

Today, financial rewards for driving patient and provider behavior have become a foundational element of any behavior change initiative. Virtually every segment of the healthcare community is deploying rewards in an effort to reduce cost, improve health, and in the case of health plans and health systems, drive loyalty and retention.  In the mid 2000s […]

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CMS Issues Final Guidance on Rewards and Incentives….Here’s What MA Plans Can and Can’t Do

On December 4, 2014, CMS issued additional guidance regarding rewards and incentive programs (“RI Programs”).  Historically, MA plans have been able to offer limited rewards and incentives to members in order to entice them to receive preventive services that had zero-cost sharing in accordance with guidelines set forth in Chapter 3 of the Medicare Managed Care Manual.  In May of 2014, CMS promulgated final […]

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Be Healthy and Be Rewarded….Health Rewards Spreading To Every Corner of Healthcare

Be Healthy and Be Rewarded….Health Rewards Spreading To Every Corner of Healthcare
Ten years ago, financial rewards for healthy behavior was considered a “fringe” technique and in others was considered morally offensive.  It was common to hear “we are not going to pay people for doing what they should be doing” or “Are we really going […]

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Health Reward Stat of the Day – Dec 29

As of July 2014, 75 percent of eligible professionals and 92 percent of eligible hospitals had received incentive payments for successfully attesting to the adoption and meaningful use of EHRs.
http://www.nationalpartnership.org/research-library/health-care/HIT/engaging-patients-and-families.pdf

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Health Reward Stat of the Day – Dec 26

To date, a wide range of health care providers — hospitals, physician practices, nurse practitioners, dentists and others — have registered for and received incentive payments under the Meaningful Use program.

Since the first fielding of this survey in 2011, nearly all hospitals in the United States have registered for these incentives (95 percent as of June 2014), with […]

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Health Reward Stat of the Day – Dec 16

According to a consumer survey of 1,200 Medicare Advantage (MA) plan members, 83.97% of respondents to the survey are likely to choose a plan that offers rewards over an otherwise identical plan that does not offer rewards. Not only can rewards be used to move plan differentiation, but the survey also found that 83.4% of respondents are […]

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Health Reward Stat of the Day – Dec 2

As of September 2014, in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs:

More than 414,000 health care providers received payment for participating
More than $16.3 billion in Medicare EHR Incentive Program payments have been made between May 2011 and September 2014.
More than $8.59 billion in Medicaid EHR Incentive Program payments have been made between January […]

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HHS OIG Releases Anticipated Proposed Rule For Anti-Kickback Safe Harbor

On Friday, October 3rd, the HHS Office of the Inspector General (OIG) issued a highly anticipated proposed rule (the Proposed Rule) that provides amendments to the Anti-Kickback Statute’s regulatory safe harbors (AKS Safe Harbors) and adds protections for increasingly common payment practices and business arrangements under the Civil Monetary Penalty Law (CMP). These amendments and updates to the AKS […]

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