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Center for Medicare Services (CMS) Modernizing with Technology

by Jagger Esch

For some Medicare beneficiaries, technology changes and advances are beyond their years. However, times are changing, and many beneficiaries are eager to embrace the change.

The Center for Medicare and Medicaid Services (CMS) is the largest single healthcare insurer nationwide. CMS pays upwards of $1.5 billion worth of claims, every day.

The digital age is upon us, our healthcare coordination wants us to know about the benefits and efficiency in using technology with healthcare. Lately, health care has taken up a large share of the U.S. economy and it’s still growing.

In fact, by 2026 it’s predicted that one in every five dollars spent in America will be on health care. As the cost of care rises, the healthcare system is working towards becoming more efficient by accommodating Medicare’s technologically inclined beneficiaries.

CMS is Keeping up With Technology

The CMS is doing more to reach those tech-savvy seniors. As the federal government plays a large part in healthcare delivery and payment, CMS is trying to give easier and more efficient ways for care coordinators to use technology to their benefit.

In early 2019, they created a podcast as well as an app that will help inform beneficiaries about Medicare and provide patients with a digital option to view their health status.

As significant advancements are made in biomedicine – health care delivery is changing for the better. These new technologies can improve the efficiency in healthcare by pushing cost-effective care; in turn, patient outcomes will see an improvement.

The focus is on encouraging innovation and making a new pathway for treating patients. CMS wants to ensure that beneficiaries can access the newest medical technologies; this will improve not only the quality of care received but lower costs while doing so.

Modernizing Medicare due to Latest Technology Advances

In October 2018, the CMS announced they’d revise Medicare’s local coverage determination process. This means more access to new technological health care services.

Medicare was signed into law in 1965, I bet they couldn’t imagine the technological developments or new therapy options we’re seeing today.

Medical technology is developing and at a fast pace. Meanwhile, Medicare’s payment systems are not. Some of Medicare payment policies haven’t seen an update in as long as 10+ years.

As you can imagine this could cause some issues. There’s a good chance some consumers will experience gaps in coverage while waiting for the FDA approval of technology and Medicare paying for the technology.

CMS is still sorting out issues and working on improving the process for covering items/services that will potentially improve the care of all patients. The goal is to help beneficiaries experience a health care system that provides the technology we’ve all grown accustomed to in other aspects of our lives.

For instance, CMS released the Blue Button 2.0 application programming interface (API). This API gives Medicare beneficiaries a digital platform to get their claims data in digital form. This means you can safely and securely use your medical information in third-party electronic applications (apps).

As almost everyone has one, smartphones are basically a way of life at this point. Due to smartphone popularity, app developers are creating programs that use claims data from Blue Button 2.0.

This is giving beneficiaries the ability to understand their health report and manage their health status in the palms of their own hands; and better yet, at their own convenience.

“What’s Covered” app

Early February 2019, the Centers for Medicare and Medicaid Services released a new app. Giving consumers a more modern Medicare experience; this app has direct access through a mobile device to some of Medicare’s most popular content.

The app is called “What’s Covered”. It gives people with Original Medicare and their caregivers an efficient way to check if Medicare covers a certain medical service and/or item.

The What’s Covered app is allowing consumers to use their mobile device to receive more consistent and accurate Original Medicare coverage information.

Some of the most searched questions for the CMS is “What does Medicare cover?”

Having access to this information while you’re at the doctor’s office, hospital, or anywhere you have a mobile connection for that matter, will help you become more educated on your coverage. In turn, will result in a better quality of care for beneficiaries and providers as well.

You can download the What’s Covered app for free in either the Apple App Store or Google Play.

Medicare goes digital: eMedicare

In 2018, the eMedicare initiative was launched by CMS to provide cost and quality information to Medicare beneficiaries. eMedicare is an app that comes with many tools for consumers to use to help them make better health care decisions for themselves and/or their loved ones.

This includes interactive online decision support designed to help you understand and evaluate your coverage options with Medicare. You can also compare costs between Traditional Medicare and Medicare Advantage plans.

Moreover, you have the option with this new online service to see how the different coverage choices will change their anticipated out-of-pocket expenses.

Transparency tools are available so beneficiaries can compare rates of specific procedures. The Medicare Plan Finder has a new web chat option within the app as well.

Of course, those with Medicare may still receive paper copies of the “Medicare and You” handbook as well as Medicare Summary Notices.

Meanwhile, eMedicare is still expanding and improving current consumer service options.

CMS Launches Podcast

February was full of CMS technological launches. The Centers for Medicare and Medicaid Services launched “CMS: Beyond the Policy,” a new podcast.

The podcast will feature updates and changes to policies and programs regarding Medicare.

These topics are presented in a conversational format, making it easily accessible to consumers. The intention of this podcast is to reach more consumers to explain the policies and programs in a fashion that’s more easily understood.

CMS Administrator Seema Verma said:

“The new Beyond the Policy podcast demonstrates our commitment to transparency and outreach by presenting CMS-related policies, updates, and innovations on as many platforms as possible…This program is a direct response to stakeholders’ suggestions that a podcast would be a modern, user-friendly way to stay informed about CMS.”

New podcast episodes will be periodically released; they’ll cover a wide range of topic experts, stakeholders, and CMS Administrator Verma as well.

You can download podcasts on iTunes here, or on Google Play here.

Digital Technology Coordinates Quality Care

According to CMS, Medicare and Medicaid patients with multiple chronic conditions make up about 15% of all beneficiaries. However, at least half (50%) of all costs spent by CMS is due to these patients.

The federal government is seeking out options to better coordinate care for chronic disease management; one option is the accelerated use of telehealth services.

For instance, one way how CMS is keeping up with technology is the new rules for telehealth services.

These new rules are making it easier for consumers to receive treatment. It’s also making it more efficient for providers to acquire authorization for the treatment of opioid patients and for those suffering from behavioral disorders.

As CMS becomes more patient-centered, they’re pushing to create pathways for success. Better coordinated care means adopting payment options for virtual care. Like, paying providers for submitting remote evaluations of photos or recorded videos submitted by their patients.

The Future of CMS Technology

CMS realizes that technology is the way of the future. As the demand grows, they work towards incorporating innovation and technology when managing patient care.

Advancements such as telehealth are beneficial for providers and consumers combined. This digital and remote option gives consumer freedom and convenience.

Whereas the provider can treat patients more efficiently because not all medical related services require an in-office doctors visit.

The population of people with Medicare is growing, in fact, the population is expected to see a 50% increase by the year 2030.

As of the year 2016, about 65% of Medicare beneficiaries stated that they use the internet or internet services almost daily.

Beneficiaries are becoming more digitally inclined; the demand for technology-related health and medical services is growing. You can expect to see more of these medical services options become available over the next few years.

This is great news! New digital and remote treatment options will result in a more efficient healthcare system.

Center for Medicare Services (CMS) Modernizing with Technology

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