Walgreens, UnitedHealthcare Team Up to Open In-Store Medicare Centers
Recently, Walgreens has teamed up with UnitedHealthcare to open in-store Medicare centers. Through this partnership, people will have easy access to comprehensive services for their specific needs and pharmacy services. Read the article below to find out more.nnMore seniors are opting into MA plans, which have become a lucrative business for insurers. Nearly one-third of all Medicare beneficiaries, or 22 million people, are enrolled in MA plans.nnThe deal gives UnitedHealthcare access to reach more members as Walgreens operates more than 9,000 drugstores with a presence in all 50 states. For Walgreens, the deal has the ability to drive additional foot traffic to stores as UnitedHealthcare commands the largest share of MA members, about 26% of the entire MA market, according to the Kaiser Family Foundation.nn”Through strategic partnerships like this, Walgreens store locations can offer comprehensive services tailored to the specific needs of the communities we serve that are conveniently accessible alongside our pharmacy services,” Rick Gates, senior vice president of pharmacy and healthcare at Walgreens, said in a statement released Monday.nnCVS Health, which owns its own insurance plan with Aetna, has made a similar move as it plans to open more than 1,500 HealthHUB stores across the country by the end of 2021. The HealthHUB stores earmark about 20% of CVS retail space to health services, with a special focus on preventive care and wellness.nnIn its bid for Aetna, CVS claimed the deal would serve as the “front door” to healthcare as a majority of Americans live just a few miles from a CVS store and tend to interact with pharmacists more than their doctor.nnOther nontraditional players, including Walmart, have jumped in the space as well. The company launched its first health superstore in Dallas, Georgia, this fall.nnThe recent developments underscore the rise of consumerism in healthcare in which more care is moving from outside the grip of hospitals to more convenient, lower-cost settings.nnComplete and original article published on healthcaredive.com
It is a word that brings dread to most people, AUDIT. The stress of an audit is real and can be felt just by walking into the room. So what can be done to help prevent all the drama? The short answer, like most things, is to be prepared. Get a plan in place and be ready when the time comes. Working with your external compliance auditors and having open lines of communication can play a big role in making sure you and your practice get the most out of it. Make sure they know what your concerns are going into their review. Have a clear and defined code set in, the addition of production reports helps to support the codes you wish to audit. In the end, they are there to help and provide an outside perspective.nnIn the November issue of the AAPC’s Healthcare Business Monthly, there is an excellent article with a six-step plan to audit success.n
Be sure to get your new Medicare card before the new year! Also, update your patients’ records before the office is hit with many new patients and appointments when the new year comes. Read below for more information from MLN Connects.nnDo not wait. Update your patients’ records and use Medicare Beneficiary identifiers (MBIs) now, before you are busy with other patient insurance changes in January.nnWe encourage people with Medicare to carry their cards with them since we removed the Social Security Number-based number; if your patients do not bring their Medicare cards with them:n
nnHappy Thanksgiving from all of us at Welter Healthcare Partners. We want to thank our partners and clients for their continuous support and business throughout the year. We are so grateful to you. We wish you a safe holiday with your loved ones.nnOvereating (R63.2) is defined in medical terms as “to eat to excess, especially when habitual.” Break the habit of this holiday and save some leftovers for tomorrow.nn 
After months of feedback from payers and providers unhappy with a proposal to mandate price transparency in healthcare, the Trump administration has now unveiled its final rule on the topic of hospital price transparency. This topic has been in talks for months and its effective date is being pushed to 2021.nnnDeclaring “a major victory” for patient choice and affordable healthcare, President Donald Trump on Friday unveiled his administration’s final rule on hospital price transparency.nn”I don’t know if the hospitals are going to like me too much anymore with this, but that’s OK,” Trump said at a White House event to announce the rule.nn”We’re stopping American patients from just getting, pure and simple, two very simple words: ripped off. Because they’ve been ripped off for years, for a lot of years,” he said.nnThe final rule—which takes effect on January 1, 2021, one year later than initially proposed—requires hospitals to provide patients with easily accessible information about standard charges for items and services offered.nnThis includes making all standard charges available in a single data file that can be read by other computer systems, as well as making “shoppable services” information available on their websites in a consumer-friendly manner.nnAdditionally, hospitals must make information about shoppable services, which can be scheduled by patients in advance, available in a “prominent location online” and describe the information in plain language.nnThe Centers for Medicare & Medicaid Services also issued a separate proposed rule that would impose price transparency requirements on health insurers.nn”I’m sure they’ll be thrilled,” Trump said of insurers. “This will allow you to see your out-of-pocket costs and other vital price information before you go in for treatment, so you’re going to know what it’s going to be and you’re going to be able to have lots of choices, both in terms of doctors, hospitals, and price.”nnThe final rule provides CMS with additional enforcement and auditing capabilities, including the ability to issue monetary fines of $300 per day for hospitals that don’t comply.nnThis announcement came less than four months after CMS released its proposed rule on hospital price transparency.nnHealth and Human Services Secretary Alex Azar applauded the president for implementing “revolutionary change” to the healthcare system.nn”Today’s transparency announcement may be a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control,” Azar said.nn
Hospitals Say They’ll SuenNot surprisingly, payer and provider stakeholders responded to the new final rule with a chorus of boos and promises of litigation.nnIn a joint statement, the American Hospital Association, Association of American Medical Colleges, Children’s Hospital Association, and Federation of American Hospitals called the proposed rule “a setback in efforts to provide patients with the most relevant information they need to make informed decisions about their care.”nn”Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery,” the hospital groups said.nn”Because the final rule does not achieve the goal of providing patients with out-of-pocket cost information, and instead threatens to confuse patients, our four organizations will soon join with member hospitals to file a legal challenge to the rule on grounds including that it exceeds the Administration’s authority,” the hospitals said.nnBeth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, said the final rule “would unfairly advantage health plans in negotiations with providers and threaten essential hospitals’ ability to participate in networks and maintain access to services.”nn”Information without context—for example, how and why the cost of patient care varies among hospitals—is of little practical use to consumers,” she said. “Essential hospitals typically have higher costs due to their commitment to complex services vital to communities, such as trauma and behavioral health care.”nnAlso, Feldpush said the final rule would create an administrative nightmare for hospitals that would hurt patient care and drive up costs.nn”These policies undermine hospital’’ ability to negotiate equitable payments while giving consumers little actionable information with which to make informed care decisions,” she said.nnOn the payer side, Matt Eyles, president and CEO of America’s Health Insurance Plans, said price transparency “should aid and support patient decision-making, should not undermine competitive negotiations that lower patients’ health care costs, and should put downward pressure on premiums for consumers and employers.”nn”Neither of these rules—together or separately—satisfies these principles,” he said.nnOriginal 
Opioid Treatment Programs (OTP’s) have been a hot topic for several years. Among several new codes set to be implemented January 1st are new HCPCS codes specifically for OTP’s. nnHere are two sequences to be aware of:nGYYY1-GYYY3 (office-based treatment)nGXXX1-GXX19 (medication-assisted treatment)nnThese new codes will reimburse with bundled payments for the treatment of opioid use disorder (OUD). Refer to