As noted in our previous blog post, Merrill Corp attended the Center for Medicare and Medicaid Services (CMS) 2010 Fall Conference earlier this month. On Day 2, before sessions on Customer Service Monitoring, QIP/CCIP Expectations and a panel on 2010 audits by the CMS Central Office Representatives, Deputy Administrator and Center for Medicare Director Jonathan Blum gave a presentation to the health plans in attendance.
Blum, who we have posted about in the past, made several key points, with the most interesting being his comments on marketing materials (CMS will be closely monitoring them to ensure accuracy and honesty) and on the change in way CMS interacts with health plans (in reaction to comments from some plans on feeling that CMS has greatly changed the way it interacts and partners with them, he confirmed that yes, there has been a change and that it is intentional). Additionally, he covered a wide-range of topics, including: - Enrollment
- Surveillance Activities
- 2011 Selling Season
- Health Reform and the Affordable Care Act (ACA)
- Plan Sponsor's Responsibilities
- Plan Risk and protection of beneficiaries
- CMS Communication to beneficiaries
From Merrill Corp's perspective, we commend the director's statements and feel that is in parallel with Merrill's philosophy on compliance-driven communications. In the coming weeks, we will dive deeper into these discussion points and provide insight on how Merrill Corp can assist with the upcoming changes.
Whew!
The Merrill Healthcare Team just wrapped up attending the CMS Fall 2010 Conference in sunny Baltimore and in addition to an excellent crab cake (ok...crab cakes 'cause who can eat just one!) what great information about all things healthcare! While all the speakers were great, the highlight of the conference was the opportunity to listen to newly appointed Director of CMS, Jonathan Blum.
Among the many topics covered at this conference were:
~ Enrollment Policy / Operations and Part D IRMAA
~ End of year transitions and MARx Activity & Enhancements with MARx Redesign & Modernization Overview
~ Customer Service Monitoring
~ Mandatory Compliance Programs
~ 2010 Marketing Guidelines & AEP Surveillance
A common theme that emerged across these presentations underscored the continual state of change we as Healthcare communicators will be dealing with well beyond 2014. Additionally, compliance-driven communications and CMS oversights will continue to challenge us in our member communications. Increased marketing surveillance and auditing are here to stay!
As we continue to grasp and operationalize the information gained, the Merrill platform for member and prospect communications will continue to set our customers apart; both to CMS and to their members.
More detailed information to come once I get a chance to digest everything I learned this week!
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Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.
Among the many announcements made at the 7th Annual World Healthcare Congress, acting director of the Center for Drug and Health Plan Choice Jonathan Blum was introduced as the new Policy Director for the Centers for Medicare and Medicaid, reporting directly to HHS Secretary Kathleen Sebillius.
In his presentation, Jonathan made several key statements:- On the Medicare side, CMS will take the lead in payment reform and quality improvement measures, stressing a desire to partner with State Medicaid and Private Payers to reduce cost, improve quality outcomes, and maximize available dollars.
- His first priorities are dealing with Part D, where the "donut hole" will be closed in a ten year period.
- CMS is also looking to contract for discounts. Changes to payments for Medicare Advantage (MA) plans will occur and have basis of payment on quality and outcomes in 2012. When plans have an increase in their quality rating and elevate outcomes, they will receive a reward of higher payments.
- The CMS Center for Innovations has been established to open in January 2011 with funding of $10 million. They are planning on creating an Accountable Care Organization (ACO) policy for Medicare Programs, Pay for Performance Systems (PPS) for hospitals. However, bundled payment will take more time. With the Center for Innovations, CMS now has the authority to take successful demonstration projects from inception to reality without having to return to Congress for approval. For unsuccessful projects, there will still be valuable information learned.
- Next steps for MA include streamlining the process for beneficiaries, developing best-care models (with an emphasis on coordination of care for members), and creating better quality and more competitive plans.
- There has not been a substantial change in the number of PFFS plans leaving the market place, however, there is an all-time high of beneficiary satisfaction in their MA plans and are increasing their request of geographical areas.
- Fraud and abuse continue to be a huge area for CMS and will continue to be addressed.
Jonathan clearly has both the credentials and contacts to be successful in his new role, and his remarks indicate that he has a firm grasp on the process to develop and implement many of the new regulations that will be addressed in the upcoming months and years.
