Medicare Set-Aside, Workers’ Compensation, Medical Case Management
CMS recently released ten years (2009 through 2019) of medical projections. The projections portray expenditures in a variety of areas, including funding source (private, Medicare, Medicaid), type of service (hospital, physician, drugs, etc.) and others.
click here to access the projections.
Senate health reform efforts will include a proposal to close Medicare Part-D’s “doughnut hole,” providing better prescription drug coverage to seniors.
Protocols Case Management: The Beers List and How Certain Drugs May be Inappropriate for Seniors
This blog is for informational purposes only. This information contained in his blog should not be used on specific files absent the appropriate consultations with treating physicians or other qualified individuals.
The medical community has been aware for many years that certain drugs are inappropriate for seniors (age 65+). As the body ages, it becomes less effective at breaking down drugs, and an accumulation may develop and result in adverse effects. Further, seniors often consume more medications than younger persons, and with each additional drug the potential for adverse reaction increases. Despite this well-documented issue, up to 25% of Medicare managed care patients are estimated to use at least one inappropriate medication (source: NCQA). Seniors who use these drugs incur more hospital visits and higher medical costs than seniors who don’t use the drugs. Read the rest of this entry »
In an effort to streamline the MSA process, CMS is attempting to offer a web-based portal by calendar year 2010.
A recent study by the Robert Wood Johnson Foundation found that many seniors are not choosing the lowest-cost plan appropriate for their situation. The study, to be published in August 2009, finds that the abundance of decisions becomes too complex to navigate.
