Executive Update: CMS Demonstration Projects and Government Reimbursement Policies

Executive Update: CMS Demonstration Projects and Government Reimbursement Policies published by Parks Associates in July, 2008. This report consists of 31 Pages and the price starts from US $ 2000.

Introduction

Abstract

This executive update provides an update on the reimbursement policy trends from the Center for Medicare and Medicaid (CMS) regarding digital health applications and services. It analyzes the status of key Medicare demonstration projects and their impact. The report also examines state-run Medicaid program' s stance on emerging digital health technologies.

“The government reimbursement policy remains a sore spot for the growth of the digital health industry,” said Harry Wang, Senior Analyst with Parks Associates. “Technology vendors should learn from the experience of the disease management industry with the Medicare Health Support Pilot program and find a better way to engage government at both the federal and state levels and eventually convince them of the value of technology to the U.S. healthcare industry.”

Table of Contents

1.0 Executive Summary

2.0 Update on the Medicare Reimbursement Policy

• 2.1 Medicare Health Support (MHS) Pilot Program
• 2.2 Medicare Medical Home Demonstration (MMHD) Project
• 2.3 Other Medicare-sponsored Demonstration Projects
  • 2.3.1 Care Management for High-Cost Beneficiaries Demonstration
  • 2.3.2 Medicare Physician Group Practice Demonstration (PGP)
  • 2.3.3 Medicare Senior Risk Reduction Demonstration
• 2.4 Most Recent Legislative Efforts and Policies
• 2.5 Medicare Policy Analysis

3.0 Reimbursement Policy from State Medicaid Programs

• 3.1 State Telemedicine Programs
• 3.2 State Medicaid Policy Trends

4.0 Implications and Recommendations

• 4.1 Medical Device Manufacturers
• 4.2 Health Service Providers

List of Figures

• DM Companies Participating in MHS Project
• Qualifications for Being Recognized as Medical Home Practice
• Reimbursement Rate Determinants for MMHD
• Participating Companies in CMHCBD Project
• State Telemedicine Networks that Cover Store-and-Forward Services
• List of State Medicaid Waiver Programs

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