Max Gatzke, DC’s Post

🚨 **Attention Medicare Advantage Plan Holders!** 🚨 Don't let new policies delay your care! UnitedHealthcare (Optum) and Humana now require prior authorization for chiropractic and other essential services, meaning your health could be at risk due to unnecessary delays. 🕒 **What You Can Do:** 📞 Call Humana: 800-758-5002 📞 Call UnitedHealthcare: 855-586-3843 **What to Say:** 1️⃣ Respect my treatment plan recommended by my physician without delays. 2️⃣ Do not create barriers to timely, effective care that helps me manage my condition without opioids. 3️⃣ Stop the prior authorization requirement for chiropractic and physical therapy care. Your health should come first—take action now to ensure you receive the care you deserve! 💪 #HealthcareAccess #MedicareAdvantage #ChiropracticCare #PatientAdvocacy

Important new brief out of the Bipartisan Policy Center: "The Future of Acute Hospital Care at Home" To ensure beneficiaries can continue to receive various levels of care in their preferred settings, the BPC brief provides immediate-term federal policy reform recommendations for the potential reauthorization of the Acute Hospital Care at Home model, including extending the waiver for five years, while outlining key issues for policymakers to consider as further data emerges. Recommendations largely align with: --Facilitating appropriate uptake and participation in the model; --Gathering evidence on the model to support high value, equitable, and comprehensive care; and --Ensuring program integrity and patient and caregiver safety. BPC spoke with a number of stakeholders in preparation for this brief, including several Coalition members. Review and share with your network: https://lnkd.in/gGsxJ22A #HospitalAtHome #HomeHealth

Understanding Alzheimer's and Medicare Coverage 🩺 Navigating Alzheimer's care can be overwhelming, but Medicare offers valuable support. Here's what you need to know: 🧠 Coverage for Treatments: Medicare Part B covers diagnostic tests, medications, and visits to doctors and specialists involved in your care. 💸 Long-Term Care Costs: While Medicare covers some aspects of Alzheimer's care, it does not typically cover long-term custodial care. It's essential to understand what is covered to plan accordingly. 🔄 Supplemental Plans: Consider Medicare Supplement (Medigap) plans to help with additional out-of-pocket costs, ensuring comprehensive coverage for your loved one. Stay informed about your Medicare options to provide the best care possible. For more information, visit gloriasantana.com. #Medicare #AlzheimersCare #HealthcareSupport #MedicareBenefits #SupplementalPlans #StayInformed #CarePlanning #gloriasantana

Journalists have also scrutinized United’s denial practices. In January, the health news outlet Stat published a detailed investigation into how a UnitedHealthcare subsidiary, NaviHealth, used algorithms to deny care for seniors enrolled in the company’s Medicare advantage plan. The Stat investigation noted specific instances that troubled United employees, like when an older woman who had a stroke was only covered for half the nursing days typically required for recovery.

New age-friendly hospital guidelines from Centers for Medicare & Medicaid Services aim to promote high-quality care for older adults including prioritizing mobility. Beginning 2025, new quality measures take effect which build on the success of the Age-Friendly Health Systems movement – the 4Ms Framework of What Matters, Medication, Mentation, Mobility. Join the Johns Hopkins Activity and Mobility Promotion team for an informational webinar covering how healthcare organizations can meet CMS requirements which will establish a foundation to develop a culture of mobility. https://bit.ly/3XbGXW2

The 2025 VBID application deadline is just two weeks away! Advance care planning requirements have changed, and Medicare Advantage plans need to be ready! There's still time for MyDirectives to help you be ready before the April 12 deadline. Book a meeting with us at https://lnkd.in/gNz5Xh-k to learn more. #VBIDModel #AdvanceCarePlanning #MyDirectives #HealthcareEfficiency #HealthEquity

Happening today! There is still time to register. Don't miss this crucial webinar with information that affects your business. Are Medicare cost reports hurting you in the long run? Join us for our webinar with the National Alliance for Care at Home, HHFMA, Forvis Mazars US, “Ensuring Accurate Medicare Cost Reports: A Key to Effective Advocacy for the Industry,” a timely topic for providers right now. Learn about the critical nature of preparing accurate annual Medicare cost reports for home health and hospice organizations, the direct correlation of reported aggregate data on MedPAC’s annual recommendations to Congress, and why that has resulted in Medicare reimbursement cuts year after year. Expert panelists include Steven Landers, MD, MPH, CEO of The National Alliance for Care at Home; Mark Sharp, CPA, and Partner for Home Care & Hospice at Forvis Mazars; and Jennifer F. Sheets, Acute and Post-Acute Healthcare Strategy Executive, Board Member for The National Alliance for Care at Home and Board Chair for Research Institute for Home Care. The conversation will be moderated by Deborah R. Hoyt, Senior Vice President of Public Policy for Axxess. Register here: https://ow.ly/Y2y450UchCw #Medicare #homehealth #advocacy

Happening today! There is still time to register. Don't miss this crucial webinar with information that affects your business. Are Medicare cost reports hurting you in the long run? Join us for our webinar with the National Alliance for Care at Home, HHFMA, Forvis Mazars US, “Ensuring Accurate Medicare Cost Reports: A Key to Effective Advocacy for the Industry,” a timely topic for providers right now. Learn about the critical nature of preparing accurate annual Medicare cost reports for home health and hospice organizations, the direct correlation of reported aggregate data on MedPAC’s annual recommendations to Congress, and why that has resulted in Medicare reimbursement cuts year after year. Expert panelists include Steven Landers, MD, MPH, CEO of The National Alliance for Care at Home; Mark Sharp, CPA, and Partner for Home Care & Hospice at Forvis Mazars; and Jennifer F. Sheets, Acute and Post-Acute Healthcare Strategy Executive, Board Member for The National Alliance for Care at Home and Board Chair for Research Institute for Home Care. The conversation will be moderated by Deborah R. Hoyt, Senior Vice President of Public Policy for Axxess. Register here: https://ow.ly/Y2y450UchCw #Medicare #homehealth #advocacy

I love to see Medicare Advantage plans subject their results to rigorous peer review, and Humana has consistently done this. This study looks at "senior-focused primary care practices" and outcomes of their MA enrollees. Cut-to-the-chase--more primary care is associated with fewer ED visits, hospitalizations, and readmissions, and other quality outcomes are quite strong compared to a similar set of beneficiaries in TM. These outcomes are consistent with other findings, such as from the MSSP ACO program. These results don't mean that current MA payment methods are accurate, but it does mean that some MA plans have a business model that aligns with beneficiary interests and are partnering with physician groups well and paying for better outcomes. Would be great to see more MA plans do this kind of research! #MedicareAdvantage #primarycare Humana Kate Goodrich Emily Boudreau Health Affairs Better Medicare Alliance https://lnkd.in/dSgQ96RD