PPT-January 2015 Medicare Benefits, Options, and Transitions Rules for People with ESRD

Audio Portion 18667401260 Web Portion wwwReadyTalkcom Code 4796976 Please join us online at wwwReadyTalkcom Follow Along with Us Online Lines are Muted During the Webinar Weve muted all the lines to help eliminate background noise as much as possible. Use these steps to help you decide which way to get your coverage Part Hospital Insurance Part Medical Insurance Medicare Supplement Insurance Medigap policy Part D Prescription Drug Coverage Part C Combines Part57373A Part57373B and usually Part D ESRD Patient Management. Improving Handoffs. Antonia Harford, MD. UNM Nephrology. OBJECTIVES. Review Epidemiology of ESRD. Mortality/Hospitalization in ESRD. Transitions of care in ESRD: . Discharge Handoffs . Retiree. Better Choices for a healthier . you. What Is . Changing 2015?. Healthcare Plan Benefits (co-pays, deductibles, etc.), Pharmacy Vendor, Tobacco Surcharge and Premiums. 2015 Open Enrollment information available on-line . 2017 . Annual Data Report. Volume . 1: Chronic Kidney . Disease. 2.  . Unadjusted.  . Adjusted. No CKD. All CKD.  . No CKD. All CKD. All. 43.8. 134.8.  . 45.6. 109.7. Age.  .  .  .  .  . 66–69. 2017 . Annual Data Report. Volume 2: End-Stage Renal Disease. 2. vol 2 Figure 9.1 Trends in ESRD expenditures, 2004-2015. Data Source: USRDS ESRD Database; Reference Table K.1. Abbreviation: ESRD, end-stage renal disease. . 2012-2014. (a) Denominator excludes missing/unknown causes of death. 2016 Annual Data Report, Vol . 2, ESRD. , . Ch. . 9. 2. Data Source: Special analysis using Reference Table H12. . Denominator . includes other causes of death and excludes missing/unknown causes of death (24.7% of patients have unknown or missing causes of death. ). Abbreviations. : AHD, atherosclerotic heart disease; AMI, acute myocardial infarction; CHF, congestive heart failure; CVA, cerebrovascular accident; ESRD, end-stage renal disease. . Figure 9.1.a Causes of death in ESRD patients, 2011-2013. (bars; scale on right), and annual change (%) in the adjusted* incidence rate of ESRD . (lines; scale on left) in the U.S. population, 1996-2013. Vol 2, ESRD, Intro. 2. Data Source: Reference Table A.2(2) and special analyses, USRDS ESRD Database. *Adjusted for age, sex, and race.. - 2tage 1enal #isease ($21#) 2uzanne ,. Kirchhoff nalyst in Health Care %inancing ugust 16, 2018 Congressional Research Service 7 - 5700 www.crs.gov R45290 Congressional Research Service SUaaAwY Me End - a nd Medicare Advantage P REPARED FOR A NTHEM P UBLIC POLICY INSTITU TE B Y HEALTH MANAGEMENT AS SOCIATES F EBRUARY 1 2 , 2020 End - Stage Renal Disease and Medicare Advantage February 1 2 , 2016 Annual Data Report, Vol . 2, ESRD. , . Ch. . 12. 2. a. The . catastrophic coverage amount is the greater of 5% of medication cost or the values shown in the chart above. In 2014, beneficiaries were charged $2.55 for those generic or preferred multisource drugs with a retail price less than $51 and 5% for those with a retail price over $51. For brand name drugs, beneficiaries paid $6.35 for those drugs with a retail price less than $127 and 5% for those with a retail price over $127. Table adapted from http://www.q1medicare.com/PartD-The-2014-Medicare-Part-D-Outlook.php. Figure . 7.1 . Sources of prescription drug coverage in Medicare enrollees, by population, 2014. 2016 Annual Data Report, Vol 1, CKD, Ch . 7. 2. a The . catastrophic coverage amount is the greater of 5% of medication cost or the values shown in the chart above. In 2014, beneficiaries were charged $2.55 for those generic or preferred multisource drugs with a retail price less than $51 and 5% for those with a retail price over $51. For brand name drugs, beneficiaries paid $6.35 for those drugs with a retail price less than $127 and 5% for those with a retail price over $127. Table adapted from http://www.q1medicare.com/PartD-The-2014-Medicare-Part-D-Outlook.php. . 2017 . Annual Data Report. Volume 2: End-Stage Renal Disease. 2. vol 2 Figure 8.1 Prevalence of cardiovascular diseases in adult ESRD patients, by treatment modality, 2015. Data Source: Special analyses, USRDS ESRD Database. Point prevalent hemodialysis, peritoneal dialysis, and transplant patients aged 22 and older, who are continuously enrolled in Medicare Parts A and B, and with Medicare as primary payer from January 1, 2015 to December 31, 2015, and ESRD service date is at least 90 days prior to January 1, 2015. Abbreviations: AF, atrial fibrillation; AMI, acute myocardial infarction; CAD, coronary artery disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; HF, heart failure; PAD, peripheral arterial disease; SCA/VA, sudden cardiac arrest and ventricular arrhythmias; VHD, . Af. Am, African American; AKI, acute kidney injury; CKD, chronic kidney disease.. vol. 2 Table 2.1 HP2020 CKD-3 Increase the proportion of hospital patients who incurred acute kidney injury who have follow-up renal evaluation in 6 months post-discharge: Target 12.3%.