avi’s Post

📢 Big news: We take over iATROS, the leading Chronic Care Manager for cardiovascular diseases and launch our care program Avi Heart. It’s a big leap to extend our service offering and primary care ecosystem. The past 3 years we established Avi Medical as leading primary care platform, integrating health care into our patients’ daily life. With the rise of expensive chronic diseases, led by cardiovascular conditions, we grow our care options for patients and health insurances. 🫀 iATROS as a proven track record of thousand of managed patients, certified MDR and published medical evidence on the effectiveness of the four care programs. Most of all, iATROS has proven, that our care programs not only increase health but bring direct and significant cost savings for insurances. Hugely important for our de-railing health system 💸 . We are proud to continue the partnerships with health insurances and look forward to extending user bases, care programs and ecosystem integration. #healthecosystem #chroniccare #healthtech

Can the Reimbursement Experience of Cardiac Implant Remote Monitoring Address the Global Care Shortage for Other Active Implants? The number of patients with active implants, including cardiac and cochlea implants, continues to rise. However, the availability of trained professionals to manage these patients and their devices has not kept pace. This growing disparity emphasizes the need for remote monitoring (RM) technologies, which can help ease the burden on healthcare providers while ensuring timely and effective care for patients. Germany Takes the Lead in Active Implant Remote Monitoring Reimbursement In January 2022, Germany's statutory health insurance began reimbursing RM for heart failure patients with cardiac implants. This landmark decision highlights the benefits of RM and sets a strong precedent—not only for cardiac care but also as a model for other active implants, such as cochlea implants. This innovative reimbursement approach boosts adoption, improves patient outcomes, and enhances efficiency in managing chronic diseases across healthcare. Key Takeaways Collaborative Care: Partnerships among healthcare providers improve RM implementation for active implants. Evidence-Based Policies: Reimbursement decisions should be guided by solid clinical data. Innovation and Adaptability: Emerging technologies can be integrated, with RM programs tailored to specific conditions. Outcome-Based Reimbursement: Tying financial incentives to patient outcomes promotes effective RM use for active implants. #RemoteMonitoring #DigitalHealth #HealthcareInnovation #Reimbursement #Telemedicine #PatientCare #HealthcareTechnology #ChronicDiseaseManagement #Pharma #MedTech #Investors #DigitalHealthInvesting #CochleaImplants

There was a great article in AAOS Now that talks about the digital and virtual musculoskeletal "front door". Charles Bush-Joseph, MD really hits the nail on the head as he explains the importance of the rise in telemedicine. As providers, we must be cognizant of virtual providers that try to get #upstream of our patients... Partnership with #OrthoLive decreases the chance that surgeons will be left out of #valuebasedcare. To all of the practices, employers and organizations that have already partnered with us... a BIG THANK YOU! A few things that are important call-outs from the article. 1. OrthoLive actually assists MSK practices with opening their digital front door. Our #virtualurgentcare is a particularly great solution with huge opportunities to go direct-to-patient and direct-to-employer. 2. OrthoLive has become a nice referral asset to practices who work with us because of the 2.5M lives we currently cover. 3. OrthoLive is #helping groups to reach their goals of direct to employer contracting. Check out the article or Visit www.ortholive.com to learn how OrthoLive can be the "front door" to #telehealth for you company. https://lnkd.in/gEqUSDsG

How is the growth of private medical insurance aiding the independent hospital market? The ninth edition of LaingBuisson’s Private Acute Healthcare UK Market Report is now available for purchase. This edition highlights key shifts in the market, with PMI growth driving expansion in the independent hospital market and self-pay revenue growth stabilising post-pandemic. This report highlights the ongoing increase in NHS-funded care, the role of independent clinics and emerging trends shaping the future of private healthcare, featuring: • In-depth, comprehensive breakdowns of hospitals, clinics, and NHS PPUs • Updates on political and regulatory impacts • Investment and profitability insights • Capacity and patient activity trends • And more Purchase your copy of this exclusive report to stay ahead and navigate this rapidly changing market: https://lnkd.in/eYQfz9jf

How is the growth of private medical insurance aiding the independent hospital market? The ninth edition of LaingBuisson’s Private Acute Healthcare UK Market Report is now available for purchase. This edition highlights key shifts in the market, with PMI growth driving expansion in the independent hospital market and self-pay revenue growth stabilising post-pandemic. This report highlights the ongoing increase in NHS-funded care, the role of independent clinics and emerging trends shaping the future of private healthcare, featuring: • In-depth, comprehensive breakdowns of hospitals, clinics, and NHS PPUs • Updates on political and regulatory impacts • Investment and profitability insights • Capacity and patient activity trends • And more Purchase your copy of this exclusive report to stay ahead and navigate this rapidly changing market: https://lnkd.in/es7CixjB

How is the growth of private medical insurance aiding the independent hospital market? The ninth edition of LaingBuisson’s Private Acute Healthcare UK Market Report is now available for purchase. This edition highlights key shifts in the market, with PMI growth driving expansion in the independent hospital market and self-pay revenue growth stabilising post-pandemic. This report highlights the ongoing increase in NHS-funded care, the role of independent clinics and emerging trends shaping the future of private healthcare, featuring: • In-depth, comprehensive breakdowns of hospitals, clinics, and NHS PPUs • Updates on political and regulatory impacts • Investment and profitability insights • Capacity and patient activity trends • And more Purchase your copy of this exclusive report to stay ahead and navigate this rapidly changing market: https://lnkd.in/eGe8sJWJ

Telemedicine has become a core part of Gastroenterology, providing a convenient and accessible way for patients to receive care remotely. However, integrating telehealth has many billing considerations that must be managed effectively. This discussion explores the current telemedicine landscape in gastroenterology and discusses key billing considerations that providers should consider to ensure seamless financial transactions and compliance. Read More: https://lnkd.in/gzP_4HxQ #gastroenterology #medicalbillingandcoding #revenuecyclemanagement #GlobeCentrix

Illegal discharges in the #dialysis industry: Illegal discharges in the #dialysis industry are an alarming and persistent issue that continues to compromise patient safety and violates patients' rights. Such discharges typically occur when a dialysis center terminates its care for a patient without legitimate reasons, disrupting treatment continuity and leaving patients without immediate access to life-sustaining dialysis care. Despite patient rights being protected under federal law, including the right to quality care, dignity, and access to grievances, LDOs have been known to employ policies that lead to questionable discharge practices, posing critical challenges that governance committees need to scrutinize. An illegal discharge can occur when a center discontinues a patient's treatment without adequate cause or fails to follow the mandatory processes for safe transfer or proper notification. The consequences of these discharges include: hyperkalemia (dangerous potassium levels), fluid overload, and risk of heart failure. Examples of Inappropriate Discharges Include: ⏭️Behavioral Issues as Justification ⏭️Financial Conflicts: Patients being discharged over disputes regarding payment or insurance coverage ⏭️Failure to Transfer Care Safely: Inadequate efforts to transfer the patient to another facility before discontinuing care, leaving patients without a vital treatment source Safety & Legal Implications Fresenius Medical Care and DaVita Kidney Care, which control a significant share of the U.S. dialysis market, have policies and practices that often contribute to these illegal discharges. In practice, these discharges violate the "Conditions for Coverage" set by the Centers for Medicare & Medicaid Services, which aim to protect patients' right to safe, quality care and ensure that facilities comply with all regulations These illegal discharges create significant safety issues: ⏭️Missed Treatments: which can result in death ⏭️Access to Alternate Facilities: Finding new dialysis centers, especially with short notice, can be nearly impossible due to capacity issues, location constraints, and waiting lists Ongoing Trends & Governance Challenges ⏭️Data shows that complaints related to illegal discharges and grievances in dialysis facilities have steadily increased over the years Root Causes of the Issue ⏭️Dialysis centers facing staffing shortages or heavy patient loads may resort to discharges as a means of "managing" operational pressures, rather than addressing underlying causes ⏭️Inadequate Legal Protection & Enforcement: While patients have rights under federal law, enforcement of those rights is inconsistent, with gaps in CMS oversight and enforcement allowing LDOs to circumvent due process without facing severe penalties What Needs to Change 💡 Enhanced Oversight by ESRD Networks 📝 Mandatory Reporting & Transparency ⚖️ Stronger Legal Repercussions 👥 Better Support & Advocacy for Patients Arlene Mullin

#INDUSTRYALERT: Yesterday #CMS unveiled another wave of major #Medicare changes in the 2025 PFS #ProposedRule. Proposed changes build on the significant 2024 updates and add to 2025 #PartD Redesign and #IRA impact. Why should #MedicareAdvantage plans care? 🔥 OVERPAYMENTS: Buried in the 2,284 pages are revised overpayment rules for #MA plans (and #VBC/risk-based providers) which apply to #RiskAdjustment upcoding and coding errors 🔥 PROFITS: Since MA plans must cover all FFS services, some proposals increase expense and require operational adjustments. Some proposals with greatest impact in MA include: 1️⃣ OVERPAYMENTS: Revised proposals for reporting and returning Overpayments to CMS. 2️⃣ #QUALITY MEASURES: Accelerated FFS alignment with #UniversalFoundation. 3️⃣ #CAREGIVERS: New payments for #caregiver training. 4️⃣ HEART DISEASE: New payment for cardiovascular risk assessment and CM. 5️⃣ #TELEHEALTH: Adjusted eligibility for various services. 6️⃣ #MENTALHEALTH: New payments for those at high risk of suicide/OD and adjustments to OUD services 7️⃣ #DIGITALHEALTH: New payment for FDA-approved BH/MH devices/apps/platforms. 8️⃣ #DENTAL: Expanded Part A/B dental coverage for dialysis patients w/ESRD. 9️⃣ HEP B: Expanded vaccine coverage with $0 MOOP in retail pharmacies. 🔟 COLORECTAL CANCER SCREENING: Removal of non-#HEDIS compliant test and new coverage for CTC procedure. What should MA plans do right now? ✅ ASSESS IMPACT: Examine impact of these proposals on your contracts and organization. Comment to CMS – your feedback matters!   ✅ BRIEF LEADERSHIP: Ensure leaders know about the proposals to begin planning for those which are finalized.   ✅ PREPARE FOR FINAL RULE: Equip impacted departments to activate against finalized changes; leverage early adoption for a strong #AEP and #StarRatings impact. ✅ REVIEW TH STRATEGY: Determine if your strategy will require adjustment if proposals are finalized. Assess #Stars or RiskAdjustment impact if proposals are finalized and design alternate workflows if needed. ✅ VENDOR OVERSIGHT: Confirm vendor status on 2024 changes and examine readiness for potential 2025 changes. Include review of #V28, #SupplementalBenefit reporting, MY2025 MA Final Rule, #HealthEquity Index, #OCR Nondiscrimination Final Rule, and the looming #Medicaid Final Rule.   For Our Vendor Partners: Many of you provide services impacted by some of these proposals. Please examine the impact of these proposals and submit comments. We’re proud to support health plans, providers and vendors during this seismic period in Medicare. Many of you have expressed challenges keeping up with regulatory updates. We're exploring new services to bridge this gap and would love your feedback. Let's chat! #ChangeIsOpportunity. Through our collective efforts, we're advocating for our communities and working towards a more effective, sustainable Medicare system. Please reach out if you need further insights or support. Comments are due by September 9.

Around a quarter of Australian eyecare patients are avoiding treatment for their condition due to cost reasons, according to new research that points to the impact of declining Medicare rebates and a mismatch between subsidised care and practising patterns. Patients faced significant financial barriers, with 36.8% reporting that they did not obtain services prescribed by an optometrist due to costs. One or more direct or indirect cost barriers were experienced by 42.6% of respondents for optometric care, and 40.4% for specialist eyecare. Lead author and researcher at the School of Optometry and Vision Science at UNSW, Dr Angelica Ly, said: “Our findings underline the considerable cost barriers people face when accessing eyecare." https://lnkd.in/ggQSpCz4