Neva Bartholomew, MD, MPH’s Post

Medicare Advantage members with unidentified SDOH challenges may not receive medical attention due to barriers to accessing the care they need. Without proper access to housing, food, or transportation, members cannot focus on other priorities, such as medical appointments. Many members with underlying health conditions may not be receiving proper treatment, while undiagnosed conditions can worsen without detection. Supporting the SDOH needs of members improves outcomes, and our case study on the topic explains how, and why. Look for "Supporting the SDOH needs of members improves outcomes" in the Library section of our website: https://sames.ky/46Zj8nT

A bill that would expand eligibility for MinnesotaCare, allowing anyone to buy into the program as part of a public option on MNsure starting January 1, 2027, was heard in the Senate Health and Human Services Committee on March 14. Supporters of the public option argue that it is needed to address the severe problem of underinsurance caused by patients purchasing high-deductible products that do not provide adequate coverage. Opponents argue that adding more Minnesotans to public programs that pay low reimbursement rates will increase financial pressures on clinics and hospitals. Read on here: https://lnkd.in/gRStZBgx #InsuranceReform #Sustainability #HealthcareForAll

We are asking that all members submit testimony in support of HB 5488: An Act Concerning Various Revisions to the Public Health Statutes. The public hearing will be on Monday 3/18 at 11 am and all testimony must be submitted prior to! This bill proposes a change in language to the MFT Practice Act to bring CT in line with federal requirements to be Medicare eligible providers. This language change would remove the barriers that many MFTs have faced in enrolling as Medicare providers. Please see details below. #mft #medicare #therapists

On Wednesday, CMS introduced the CY25 Medicare Physician Fee Schedule proposed rule, setting out payment guidelines for Medicare Part B. Despite an expected 2.8% reduction in the conversion factor, numerous family practice initiatives result from AAFP advocacy efforts. Notably, the proposal would allow for the utilization of G2211 in conjunction with annual wellness visits, vaccine administration, and preventative services under Part B. Team AAFP is currently assessing the rule and will provide feedback to CMS in the upcoming months. In the interim, we urge Congress to tackle the persistent issues with physician payment and implement reforms that prioritize the needs of Medicare patients. #fightingforfamilymedicine #aafpadvocacy

🚨 **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

Study from our most recent issue on The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries in the Axios Health Newsletter Full study here: https://lnkd.in/eYgDjDU9

Today the Centers for Medicare & Medicaid Services has published a rule that finalizes additional payments for hospitals providing care to unhoused individuals and introduces structural quality measures for age-friendly care, which are significant enhancements to the Medicare program. However, the rule also establishes the Innovation Center's Transforming Episode Accountability Model (TEAM) for five surgical episodes, including Lower Extremity Joint Replacement, Surgical Hip Femur Fracture Treatment, Spinal Fusion, Coronary Artery Bypass Graft, and Major Bowel Procedure. It will be fascinating to see how stakeholders react and make decisions regarding advocacy and preparation for participation in light of this development. I have extensive knowledge of policy issues and the resulting changes for all three major CMMI episode-based payment models (BPCI Classic, BPCI Advanced, and CJR). Feel free to comment below or send a direct message if you'd like to talk more about it. #IPPS #Medicare #SDOH #valuebasedcare #episodebasedpaymentmodel #TEAM #CJR #BPCI #CMS

Advocacy Alert! 🛎️ Did you know that Medicare payments to clinicians and healthcare settings do not keep up with increasing costs of performing care? Without action, 2025 will be another year where Medicare will reduce payments. Professional healthcare organizations across the U.S. are working together to have Congress pass the MEDICARE PATIENT ACCESS AND PRACTICE STABILIZATION ACT (H.R.10073). Click the link below to advocate for America’s older adults. Takes less than 2 minutes! https://lnkd.in/eKUQ6-Fa

I had the opportunity to speak with Lauren Flynn Kelly from AIS Health, about the growing need for Medicare plans designed specifically for AAPI seniors. Along with our VP of Product Andy H., we discussed how we’ve tailored our benefits, services, and partnerships with providers and vendors to meet the distinct needs of this underserved population. At Clever Care, we're committed to going the extra mile to provide culturally sensitive care that AAPI seniors deserve. https://lnkd.in/gpaXtraJ

🚨 **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