12-19_December Newsletter.pdf - Matthew Clemente

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December 2020 Reimbursement & Healthcare Economics Newsletter CMS Announces New Model to Advance Regional Value-Based Care in Medicare Direct Contracting Model Builds on CMS’ Long-Standing Commitment to Improving Quality and Lowering Costs  The model will test an approach to improving health outcomes and reducing the cost of care for Medicare beneficiaries in multiple regions and communities across the country.  Participants will take responsibility for beneficiaries’ health outcomes, giving participants a direct incentive to improve care across entire geographic regions.  Within each region, organizations with experience in risk-sharing arrangements and population health will partner with health care providers and community organizations to better coordinate care.  Beneficiaries in the model will maintain all of their existing original Medicare benefits, including the ability to see any provider they choose.  To help with delivering improved outcomes, participants may create a network of preferred providers, armed with the Model’s enhanced flexibilities to provide the right care for beneficiaries at a lower cost.  Participants and preferred providers may choose to enter into alternative payment arrangements, including prospective capitation and other value-based arrangements.  Participants will also work to augment Medicare’s current program integrity efforts, reducing fraud, waste, and abuse in their region and decreasing costs for beneficiaries and taxpayers. Source: CMS Who Cares About Total Cost of Ownership (TCO)? According to Modern Healthcare - Medical Supplies and Equipment Account for Biggest Spike in Healthcare Spending  Healthcare organizations more than ever need to effectively plan for and reduce TCO.  Hospitals are spending billions on medical equipment lifecycle costs.  Significant challenges loom for large healthcare organizations, GPO’s, IDN’s and others that include but are not limited to; o Understanding what is included in TCO and the entire lifecycle process  It is not only about the price o Defining priorities and if TCO worth the return on investment o Gathering as much information as possible for decision-making purposes o Clearly defining cost reducing strategies Source: Accurent/Journal of Healthcare For Internal Use Only Getinge is a leading global provider of innovative solutions for operating rooms, intensive-care units, hospital wards, sterilization departments and for life science companies and institutions. Based on first-hand experience and close partnerships, Getinge offers innovative healthcare solutions that improve every-day life for people, today and tomorrow. CAUTION: Federal (US) law restricts this device to sale by or on the order of a physician. Refer to Instructions for Use for current indications, warnings, contraindications, and precautions. Copyright 2020 Getinge AB or its subsidiaries or affiliates • All rights reserved. Getinge Reimbursement Hotline Please Remember to Refer All Reimbursement Questions to Our Reimbursement Hotline Getinge USA has a Dedicated Reimbursement Hotline:  Our hotline is designed to help hospitals/physicians with everyday reimbursement questions related to procedures involving our products.  Qualified reimbursement specialists are ready to answer questions like: o What code(s) apply to procedures involving our product(s)? o How do we preauthorize this procedure with private payers? o Does Medicare require preauthorization? o What do we do in the event of claims denial? o What documentation do we need to submit with our claim? Hotline Contact Information: Reimbursement Hotline phone: 1 973 709 7716 Reimbursement Hotline email: [email protected] Mario Vanini Director of Reimbursement and Healthcare Economics Cell Phone: (603) 233-7720 Office Phone: (603) 864-5229 [email protected] For Internal Use Only Getinge is a leading global provider of innovative solutions for operating rooms, intensive-care units, hospital wards, sterilization departments and for life science companies and institutions. Based on first-hand experience and close partnerships, Getinge offers innovative healthcare solutions that improve every-day life for people, today and tomorrow. CAUTION: Federal (US) law restricts this device to sale by or on the order of a physician. Refer to Instructions for Use for current indications, warnings, contraindications, and precautions. Copyright 2020 Getinge AB or its subsidiaries or affiliates • All rights reserved.