In the News: April 27–May 3

Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.

CMS Sends (Overdue) MIPS Participation Status Letters

Last week, CMS announced that Medicare Administrative Contractors are sending letters to inform providers of their Merit-based Incentive Payment System (MIPS) participation status for 2017. These letters tell practices and clinicians if they are excluded from MIPS due to the low-volume thresholds, based on Medicare Part B claims data.

Sg2 will continue to closely track the MIPS evolution over the coming year. Providers who want to understand MIPS and MACRA can review the Sg2 special report MACRA: Answers, Impact and Strategic Imperatives for answers to frequently asked questions on MACRA, as well as a detailed action plan to help you respond to MACRA in a way that fits you, your clinicians and your market.

Personalized Medicine Has Arrived

Genetic testing company 23andMe was recently granted FDA approval to provide screenings for genetic health conditions, which means patients will gain the ability to learn about their genetic makeup without seeing a physician. This marks a turning point in health care consumerism, as companies with sophisticated diagnostic capabilities work to empower patients with genetic health risk knowledge. To keep up with these advancements, the FDA has developed precisionFDA to foster collaboration among researchers and companies in developing standards for the next generation of genomic sequencing.

Sg2 believes that as more patients gain access to their genetic profiles, hospitals will need to prepare for a surge in both diagnoses and self-diagnoses, follow-up treatments and diagnostics. To learn more about recent developments in precision medicine and how they may impact your service delivery, check out the Sg2 netcast Health Tech Weekly: Ordering Some New Genes…Tests.

Adult Chronically Uninsured Rate Falls to 7.6%

A recent CDC Report found that an estimated 7.6% of adults under age 65 were uninsured for more than one year when surveyed between January and September of 2016, which represents a decrease in the chronically uninsured (those without insurance coverage for more than a year) from 16.8% in 2010. However, while the share of the chronically uninsured decreased for adults aged 18–64, it increased for adults aged 35–44. According to the CDC, a persistent lack of insurance is associated with less utilization of health services and access to care.

Sg2 understands how significant gaps in care can make chronic disease management of the uninsured population a challenge. To learn how Virginia Commonwealth University Health System pursued a tiering strategy to meet the needs and manage the costs of the uninsured medically indigent, read the Sg2 case study Tiering Strategy Reinforces Safety Net.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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