Chris Santarsiero, M.B.A.

📨 Get your comments in! Chronic health care conditions are driving costs in our health care system making up trillions (yes with a t) of dollars that could be spent on ensuring individuals remain healthy in the first place. #healthcare #health #healthpolicy #congress #chroniconditions #healthcarecosts #physicians #preventativecare

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Health systems are looking for more cost-effective ways to provide care to people at home. While many have opted to join the Centers for Medicare and Medicaid Services' hospital-at-home waiver program, others are setting up their own alternatives -- including virtual programs. Check out Diane Eastabrook's latest piece on hospital-at-home programs. https://lnkd.in/gj63PbMV

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The Centers for Medicare & Medicaid Services released some welcomed news this afternoon that shows the power of accountable care. Medicare will remove the effects of apparent fraud of catheters from ACO calculations in 2023. If you recall, ACOs this winter identified dramatic spikes in spending from urinary catheter supplies. It turns out that what is normally around $150 million in annual total Medicare spend had ballooned to more than $3 billion in one year. ACOs spotted this in their data and began to raise heck about it. We at the National Association of ACOs and others helped raise the issue's profile. And today, CMS took steps to hold ACOs harmless from what it calls "significant, anomalous, and highly suspect" claims. The proposed rule closely mirrors what NAACOS had been asking for. Nowhere outside of CMS’s claims processing operation are eyeballs scrutinizing spending as closely as ACOs. It doesn’t have to be outright fraud, but areas of waste and inefficiencies. While the promise of value-based care and ACOs continues to be questioned by policymakers as recently as this week, today's news shows some of the many unappreciated benefits that ACOs bring our health system. https://lnkd.in/dr-SRAvm

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Check this from ADA! Thanks ADA for creating education tool that help to 1) Supplement in verbal instructions. 2) Teaching aids that makes learning permanent. 3) Teaching aids that provide variety 4) that are appropriately sequenced, 4) simple, clean, and straightforward. Love it! Direct link https://lnkd.in/e-v3eYGG

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The FTC is investigating the two largest #dialysis providers who control over 70% of the market for dialysis delivered in outpatient centers. This is a highly consolidated industry, and these big players use #noncompetes to restrict physician mobility. Medicare beneficiaries have a strong interest in a mobile, well-trained physician workforce able to work in all settings, include the home. Medicare invests around $17-$18 billion annually in GME and IME physician training support to hospitals (i.e., those of us who pay Medicare payroll taxes all our working lives invest in physician workforce training). Perhaps #Medicare should consider banning #noncompetes in its "conditions of participation" for hospitals and other providers like dialysis centers. #antitrust Federal Trade Commission Centers for Medicare & Medicaid Services

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https://lnkd.in/ekuJtgW4 Examples here of what is happening at the state and federal level to advance respite care, which we must support through any transitions. States are employing various means of reaching diverse and needy families through single touch points and coalitions with other entities such as faith-based organizations. I was happy to see that academia was mentioned at least in one example as part of coalition building. Also mentioned are recruitment strategies for building respite workforce. Some states are hitting all the right buttons and these should serve as models for other states, and also for expanding help to other areas beyond respite. The best way you can ensure innovative programming at the state and federal level is to let your legislators know that these are priorities. These efforts require financial support. #newagingpartnership #caregivingconfidential #respite #nationalacademyforstatehealthpolicy #caregiving

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"Exploring the Crisis of Primary Care Wait Times" Digging into the pressing issue of primary care access, a striking statistic caught my attention: an unprecedented national average wait time for patients to see primary care physicians. It's clear we're facing a crisis that threatens not only patient health but the foundational principles of our healthcare system. The takeaway for us as healthcare professionals, policymakers, and advocates is multifaceted. This isn't just about numbers; it's a reflection of a deeper systemic failure that requires innovative solutions, strategic policy changes, and a renewed focus on healthcare accessibility. How we respond to this challenge will shape the future of primary care and, by extension, the overall well-being of our communities. For a deeper dive into the dimensions of this crisis and the potential pathways to meaningful reform, I encourage you to read the full article: https://buff.ly/4aXNlWj #healthcare #crisis #policy #hospitals

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Something positive is happening for primary care. #Medicare and other federal leaders are taking steps to boost payment and offer primary care alternative payment models like bundles and hybrid partial cap that enable proactive, population health and support for digital health. Here is an impressive list of all the good things happening for primary care. It almost feels like momentum. The shiny objects come and go, but it's primary care that must be there for all of us to navigate our way to good health over our lifetime-- with the help of the shiny objects that actually work for us. #primarycare Ann C. Greiner Shawn Martin Kate Goodrich Scott Conard, MD Health Affairs Primary Care Collaborative https://lnkd.in/evXYYA9w

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Many of the headlines about the work of Medicaid renewals focuses on the challenges - systems glitches, missed paperwork, lapses in coverage. What doesn't get as much attention are the wins - the successful renewals for tens of millions of people, the steady improvements in communication and automated renewals, the strengthened partnerships across states and territories, the federal government, and the many stakeholders who care about Medicaid. Read this important piece from NAMD's Executive Director Kate McEvoy to learn more about the good work that's taken place to date and what's next on Medicaid renewals.

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Check out my latest! In collaboration with Aasta Mehta at the City of Philadelphia – Department of Public Health we set out to understand how the numerous organizations involved in abortion care in Philly worked together, and we asked for their advice about how the dept could help their work post Dobbs. Here’s our process and a step by step guide for you to do the same in your city!

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So, the pendulum has swung back in favor of AHPs: https://lnkd.in/efNVF6nS #ahp #healthpolicy

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Quality in health care and equity in health outcomes are inextricably linked. Our team, along with taskforce members, have compiled practical approaches to demystifying bringing together quality and equity.

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https://lnkd.in/exXXunaX A couple of bills on the table to support family caregivers experiencing work disruptions by allowing catch up contributions to retirement savings accounts to begin earlier in one's life; and, allowing people to use their medical savings accounts to pay for parents' needs. Also mentioned here is the need for a comprehensive approach that includes employers getting on board with providing benefits. You know my thoughts by now, and the latter, at least, is something that we can begin to do right now. Both of the bills are bipartisan which gives us some hope, but remember what happened to the Border bill. We have to put pressure on our legislative representatives. We are voting now. Find out where your prospective elective officials stand, and if they will fight for you. #newagingpartnership #caregivingconfidential #caregivingsupport

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It's more important than ever for private practices and health centers to achieve long-term sustainability & financial security. Joining an Accountable Care Organization can help alleviate those concerns and more. Watch our on-demand webinar at https://ow.ly/QA8950Rvl57

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In the #340B Spin Room Predictably, covered entities and their advocates are in full spin mode following the Health Resources and Services Administration (HRSAgov), HHS, announcement that the program expanded by an astonishing 24% last year. The spin room’s spin doesn’t seem particularly convincing to me, but, more to the point, it ignores the patient. Here’s the spin as catalogued in a (very interesting) article by William Newton at the 340B Report, citing an impressive array of covered entity #advocates: 1) “The growth in total 340B purchases last year was largely a result of drugmaker #price increases….”; “Exploding drug price increases” are the primary reason for the program growth. I think not. As IQVIA has reported, “[o]verall spending growth in the U.S. market for #medicines slowed to 2.5% in 2023”. The 24% increase in 340B is almost 10x that rate of growth. Indeed, the article concedes a fundamental point that should have DECREASED 340B sales, measured, as HRSA did, based on dollars. As the article notes, quoting an advocate, “a new provision of the #InflationReductionAct“, which was implemented in 2023, “began penalizing #drugmakers for raising prices faster than #inflation, leading manufacturers to SLOW the rate of price increases….”. 2) The #HRSA report, another advocate says, “did not offer a side-by-side comparison to the non-340B prescription drug market”. Sorry. Nope. See above. The increase in the total market, inclusive of both non-340B and 340B, was 2.5%, while 340B increased 24%. 3) “Broader #healthcare trends” are “increasingly shift[ing]” care “from inpatient to outpatient settings”, and 340B is an outpatient only program. Well, sorry, that doesn’t really explain last year. Though it’s certainly true that, over the last 20 years, #inpatient services have declined and outpatient services have increased, #outpatient visits per 1000 people increased ONLY 0.3% from 2022 to 2023. But, for me, all of the sturm und drang over expansion isn’t even the be all and the end all of the debate; the patient is. And that’s where the spin really falls short. There’s no assertion in the spin room that assistance to patients at the #pharmacy counter has increased by 24%—or anything approaching that. Indeed, when IQVIA looked in 2022 at #patient assistance at contract #pharmacies, it found that a meager 1.4% of those patients received #assistance. Nor is there any suggestion in the spin room that charity care increased 24%. In fact, charity care percentages are moving COUNTER to 340B expansion. According to the Pioneer Institute, 340B hospital charity care ratios FELL by 46% from 2013 to 2022, with just 2.28% of operating expenses devoted to charity care in 2022. The spin just isn’t convincing. #lifesciences #drugpricing #patientsfirst #medicaldebt #affordability #Medicare #Medicaid #copays #coinsurance #costsharing #insurance

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Happy Opening Day of Medicare Open Enrollment for those who celebrate! 🎉 😃 ChenMed has over 100 senior medical centers serving tens of thousands of older adults. Our coordinated care model aims to enable our patients to live healthier, longer and more fulfilling lives, by helping them have “more good days” and better outcomes. We serve patients who are enrolled in a Medicare Advantage insurance plan. Depending on the location, we accept insurance plans offered through multiple carriers. As you and your family members contemplate your Medicare choices during the next several weeks, consider: • Is the health insurance plan you are considering aligned to providers, who treat the patient as a whole person versus merely the sum of medical diagnoses? • Are the benefits offered in the insurance plan you are considering, ones that you will actually use throughout 2025? (Once you decide on a policy, post a list of your annual benefits someplace you will see often, so you are reminded to leverage them throughout the year). • What will your out-of-pocket premiums and expenses be, if any? (Many beneficiaries qualify for insurance plans with zero dollars out-of-pocket). • How will the changes from the Inflation Reduction Act related to lowering the cost of some prescription drugs, impact your financial bottom line in your Part D insurance policy? As you consider all your health provider and insurance options, take time to consider what is most important to you or your family member as an individual.

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Brag Moment: Advanced Health Outcomes' CEO, Dr. Sharon Hibay, was reaccepted to the Mathematica and Centers for Medicare & Medicaid Services CCSQ Hospital Harm Technical Expert Panel (TEP) for measure development. Such a great way to give back to our healthcare industry, generating measures that genuinely drive care transformation, outcomes, and just accountability. #MeasureGeek #PatientSafety #ReduceHospitalHarm

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📢 Exciting News! 📢 The American Telemedicine Association (ATA) and ATA Action are committed to thoroughly reviewing the 2025 Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) proposed rules released by the Centers for Medicare & Medicaid Services earlier this afternoon. Our goal is to ensure telehealth remains a cornerstone of modern healthcare. As I mentioned in our press release, "We are eager to work with CMS and the Biden administration on the draft rule to ensure that telehealth remains a cornerstone of modern healthcare. Our extensive, broad-based ATA and ATA Action community will be offering thorough comments to ensure that the proposed policies support sustainable, high-quality healthcare delivery." The urgency for Congress to act on extending or making permanent the pandemic-era telehealth flexibilities in the Medicare program cannot be overstated. With a bipartisan consensus, now is the time to act to maintain the progress we have made. Read our full press release below for more details on this important development and our ongoing advocacy efforts. Let's continue to advance telehealth and ensure accessible, high-quality care for all! #Telehealth #HealthcareInnovation #ATAAction #PublicPolicy #Medicare #CMS

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