Posts Tagged ‘cms’

Preventive Services

Friday, June 24th, 2011

Preventive Services

The Centers for Medicare and Medicaid Services (CMS) released a new report showing that more than 5 million Americans with traditional Medicare – or nearly one in six people with Medicare – took advantage of one or more of the recommended preventive benefits now available for free because of the Affordable Care Act.   Medicare wants to raise awareness about all of the important preventive benefits now covered at no charge to patients, including the new Annual Wellness Visit benefit created by the Affordable Care Act.  

 “I am committed to ensuring that the Medicare beneficiaries we serve are aware of and take advantage of their Medicare preventive benefits.” Assistant Secretary for Aging Kathy Greenlee.

According to the report, over 5.5 million beneficiaries in traditional Medicare used one or more of the preventive benefits now covered. The covered services do not have co pays and include mammograms, bone density screenings, and screenings for prostate cancer. 

In 2011, Medicare began covering an Annual Wellness Visit at no cost to Medicare beneficiaries.  As part of that visit, beneficiaries and their physicians can review the patient’s health and develop a personalized wellness plan.  Over 780,000 beneficiaries received an Annual Wellness Visit between January 1 and June 10. Additionally, more seniors have used the Welcome to Medicare Exam this year. The Welcome to Medicare is a one-time preventive health exam available to enrollees in the first 12 months they have Part B.  66,302 beneficiaries had taken advantage of the benefit by the end of May 2011, compared to 52,654 beneficiaries at the same point in 2010 – a 26 percent increase.

The new annual wellness visit can help spark the beginning of an ongoing conversation between patients and their doctors on how to prevent disease and disability.  Patients should take advantage of this time by reviewing their histories and making sure their primary care doctor knows about their other providers and prescriptions. They can also talk about the pros and cons of getting an influenza, pneumococcal or hepatitis B vaccination, or find out whether a diabetes test, a bone mass measurement, or any of several cancer screenings would be right for them.  Thanks to the Affordable Care Act, Medicare now covers many of these services without cost to patients.

  You can find additional information on prevention benefits on line at www.Medicare.gov, and at www.healthcare.gov

Healthcare Reform and New Jersey

Thursday, December 17th, 2009

Healthcare Reform and New Jersey

As you may know, the Senate is currently debating healthcare reform.  The many amendments that are pending each require 60 votes to pass. We’ve all witnessed much debate and questioning on this topic, what we aim to do here is breakdown some of the key issues as well as, discuss what reform would mean in New Jersey.

First, a new report from the Center for Medicare and Medicaid (CMS) shows that healthcare reform bill could be a cost savings for many. According to a recent White House Blog, the bill could add years to the life of Medicare, lower costs for seniors and slow the rate of healthcare cost growth. Specifically, the report speculates that it can extend the life of the Medicare trust fund by nine years. In regard to their statement about saving seniors money, CMS reports that by 2019, the bill would save seniors nearly $700 per couple, reducing premiums by more than $300 per year and out of pocket costs by another $370 per year. CMS also predicts that as savings from reform kick in national health expenditures are projected to increase at a slower annual rate.

Some of the other areas that experts have indicated additional cost savings in are injecting accountability, competition and choice into the system through the insurance exchange; giving providers incentives to coordinate care; and transforming Medicare payment policies to reward quality of care (not quantity).

That leads us to the “exchange”, otherwise known as the public option. Some say the insurance exchange is a key element in providing coverage to the currently uninsured and making insurance more affordable for those who buy coverage on their own. Simply stated the exchange would be an entity that offers a choice of plan in an organized and competitive market. The exchange could also establish some common rules regarding offering and pricing of insurance coverage and provide the consumer with information to help them understand what is available. Much controversy surrounds the idea of a public, government-run plan being included in the exchange, as amendments are made and voted on, only time will tell if this will be an option or not. A hope expressed by many, including New Jersey Representative Rush Holt, is that the exchange, with or without a government-run plan, will allow more Americans to access coverage that currently is not available to them. That may mean including income-based plans other than Medicaid for those that find themselves above the income guideline for that program, but still can’t afford commercial insurance coverage.

So, you may be wondering, what does that mean for New Jersey? According to the Employers Association of New Jersey (EANJ), 95% of the state’s businesses employ 50 or fewer employees; this represents nearly 1.36 million people. Many uninsured adults are employed by small businesses that find healthcare too costly. Healthcare reform, specifically the “exchange”, would allow for those individuals to obtain affordable healthcare coverage.  EANJ also reports that healthcare premiums in New Jersey rose almost 5 times faster than wages in the past decade. If healthcare reform is able to create some rules and standards regarding the cost of coverage and companies abilities to deny coverage, perhaps this disparity would not be so great.

Lastly, Representative Rush Holt has done much to educate his constituents about healthcare reform; his website contains many links with information about the bills. Some of the statements regarding how New Jersey could benefit from the passing of healthcare reform are: improving employer based coverage, credits to help pay for coverage for households that are uninsured, allowing small businesses to obtain affordable health care coverage and providing tax credits to help reduce health insurance costs, improving Medicare, including closing the prescription drug donut hole and reducing the cost of uncompensated care for hospitals and health care providers by $38 million.

Want more information? Have something to add or a question to ask? Please contact your Senator!

Frank Lautenberg

Robert Menendez

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