Ardelyx, Inc.’s Post

Early identification of #sepsis is crucial for better patient outcomes. Centers for Medicare & Medicaid Services (CMS) has included the SEP-1 bundle in Medicare's Hospital Value-Based Purchasing Program (VBP). Further optimization of sepsis care is possible with the addition of innovative diagnostic tests like the T2Bacteria and T2Candida Panels, which identify bloodstream infections directly from a whole blood sample, often before the second dose of empiric therapy is administered. https://ow.ly/gofH50PBZuK

Exciting Partnership Alert: @SceneHealth and @CareFirst Broaden Scope for Medicaid Disease Management! 🎉 We're thrilled to share that Scene Health and CareFirst BlueCross BlueShield have enhanced their collaborative efforts, significantly enriching the MedEngagement program for Medicaid recipients battling asthma, hypertension, and type 2 diabetes. This program exemplifies personalized healthcare, precisely formulated to meet the needs of the Medicaid populace by offering comprehensive care and superior disease management. As a result of this joint venture, Medicaid members across Maryland will now benefit from heightened daily support and robust health outcomes. Innovatively disrupting chronic disease management, Scene Health introduces an engaging medication adherence model through video Directly Observed Therapy, a pioneering step within Medicaid services. Here's an applause 👏 for Scene Health's relentless pursuit of innovation and CareFirst's unwavering commitment to advancing Medicaid services. This collaboration goes beyond business—it represents a deep-rooted dedication to the community's well-being. 🔗 Learn More https://buff.ly/3xlUv84 Your experiences matter to us. How have innovations like these influenced the strategies within your Medicaid-focused organization or policymaking? #MedicaidInnovation #HealthCareFirst #Medicaid #DiseaseManagementExcellence #StrivingForCommunityWellness #HealthEquityInAction

After more than 10 years personally working to achieve this, it is so gratifying to know that thousands of patients will benefit from the miracle of diagnostic radiopharmaceuticals as a result.

The comment period is open for the 2023 Measure Set Review (MSR) Draft Report.  The goal of MSR is to optimize the Centers for Medicare & Medicaid Services (CMS) Medicare quality programs measure portfolio via measure removal recommendations. The 2023 MSR will review the measures included in the CMS End-Stage Renal Disease Quality Incentive Program (ESRD QIP). Comment by 11:59 p.m. (ET) on September 25, 2023: http://bit.ly/48iB526

This update applies to Medicare Advantage (MA) participating providers. Effective April 1, 2024, Aetna Medicare Advantage will no longer reimburse additional unit value(s) for Anesthesia Physical Status modifiers to align with the Centers for Medicare & Medicaid Services (CMS) guidelines. • Modifier P1 (a normal healthy patient): 0 units • Modifier P2 (a patient with mild systemic disease): 0 units • Modifier P3 (a patient with severe systemic disease): 1 unit • Modifier P4 (a patient with severe systemic disease that is a constant threat to life): 2 units • Modifier P5 (a moribund patient who is not expected to survive without the operation): 3 units • Modifier P6 (a declared brain-dead patient whose organs are being removed for donor purposes): 0 units 

Understanding Cancer and Medicare Coverage 🩺 Navigating cancer treatment can be challenging, but knowing how Medicare supports you can make a significant difference. Here’s what you need to know: 💉 Chemotherapy Coverage: Medicare Part B generally covers chemotherapy administered in a doctor's office or outpatient setting, while Medicare Part D may cover oral chemotherapy drugs. 💸 Co-Pay Costs: While Medicare covers a significant portion, you may still have co-pays and coinsurance. It's crucial to understand these costs to plan your finances better. 🔄 Supplemental Plans: Consider Medicare Supplement (Medigap) plans to help cover additional out-of-pocket costs like co-pays, coinsurance, and deductibles. These plans can provide peace of mind and financial stability during your treatment. Stay informed about your Medicare options to ensure you receive the best possible care while managing costs effectively. We are here to help. Contact us at  +1 602-551-7207 #Medicare #CancerTreatment #ChemoCoverage #SupplementalPlans #HealthcareSupport #MedicareBenefits #gloriasantana

As obesity impacts 40% of Medicaid enrollees, only 1 in 5 state Medicaid programs cover anti-obesity medications like Wegovy according to a new study in JAMA. This comes at a time when these medications show not just weight loss benefits but also protective effects against obesity complications. However, the high cost poses a challenge for state budgets. The study suggests the necessity for better price negotiations to make these beneficial treatments more accessible to Medicaid patients. This may improve health outcomes while managing costs. What do you think? Would it pay off in the "long run"? State Medicaid Coverage and Reimbursement of Antiobesity Medications

🔔 Important Update: Medicare to Cover Weight-Loss Drug semaglutide (Wegovy) for Certain Patients 🔔 Medicare has announced that it will now provide coverage for the weight-loss medication under its Part D drug program. This coverage is intended for patients with overweight or obesity who have preexisting heart disease and require the drug to lower the risk of heart attacks and strokes. 🏥💊 The Centers for Medicare & Medicaid Services (CMS) shared that their decision is aimed at ensuring individuals have access to treatments that can enhance health outcomes. Following the recent FDA approval for the expanded use of Wegovy, current Medicare Part D and Medicaid coverage guidelines will be applicable. 💊 #Medicare #Wegovy #WeightLoss #Healthcare #FDAApproval

Register for National Organization for Rare Disorders, Inc. (NORD)'s webinar on September 14, to understand how changes to the Medicaid renewal process will impact you, and gain tips to successfully navigate Medicaid renewals to ensure you do not lose coverage. https://buff.ly/3PCpHXv

Depending on wound type and comorbidities, complex wounds differ in both etiology and treatment pathway. The diverse nature of complex wounds necessitates tailored, evidence-based treatment plans and avoiding one-size-fits-all approaches that are often expensive and unproven. At Woundtech, we understand the distinctive nature of complex wounds and what is required to heal them. Woundtech brings wound healing to the patient’s home at a lower cost than clinic-based providers. Our provider-driven model is based on tailored, evidence-based care that is grounded in data and science—not fads. Across 23 years, Woundtech clinicians have made over 1.5M wound-related patient visits, serving Medicare Advantage, Medicaid, Commercial, and SNP patients across 7 states. Click here to learn more! https://hubs.la/Q02f2tWG0 #woundcare #whyWoundtech #healthcare #providerdrivencare #experiencematters