Crescent Moore, PharmD, PhD, BCPS, senior consultant, BluePeak Advisors, discusses how CMS is planning on implementing care coordination programs in Medicare.
Crescent Moore, PharmD, PhD, BCPS, senior consultant, BluePeak Advisors, discusses how CMS is planning on implementing care coordination programs in Medicare.
Transcript
How is CMS planning to implement care coordination programs in Medicare?
This is another situation where we’re not given a ton of guidance in terms of necessarily if CMS has an exact way of how they want those care coordination programs to be administered. We have the requirements in terms of needing to address medication adherence and really looking at a medication review and really being able to describe to the member what drugs are impacted by the Part B step therapy. I think plans are going to have to look at what makes sense for them. I’ve talked to some plans, and they have really thought more about expanding their current case management programs. So, rolling those members who would be a part of that Part B step program into their case management programs to address this.
Another program that’s already established in the Part D side that could be expanded as well is the Medication Therapy Management program, which really does already address many aspects that CMS is expecting to see in the care coordination programs.
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
After the ACA Expanded Health Care Access, 2024 Elections May See Voters Demand Affordability
May 15th 2024At the spring conference of the New Jersey Health Care Quality Institute, speakers discussed how health policy, affordability, and transparency may play a role in voters’ decisions.
Read More
Panel Addresses Minority Physician Shortage, Maternal Health at Senate Committee Hearing
May 15th 2024The senate hearing held by the US Senate Committee on Health, Education, Labor, and Pensions, led by Sen. Bernie Sanders (I, Vermont), chairman of the committee, and ranking member Sen. Bill Cassidy, MD, (R, Louisiana), addressed the critical issue of physician and health care worker shortages, as well as the maternal health crisis, in the US.
Read More