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NEW rules for Medicare Shared Savings Program

Benistar shares announcement from the cms.gov website released June 5, 2015

The CMS finalizes rules for Medicare Shared Savings Program

Continued Growth in ACO Program is a Core Component of Delivery System Reform

The Centers for Medicare & Medicaid Services (CMS) today released a final rule updating the Medicare Shared Savings Program to encourage the delivery of high-quality care for Medicare beneficiaries and build on the early successes of the program and of the Pioneer Accountable Care Organization (ACO) Model.  This final rule is an effort to provide support for the care provider community in creating a delivery system with better care, smarter spending, and healthier people.

The Medicare Shared Savings Program final rule will both enhance the focus on primary care services and provide additional flexibility in the program, which should grow participation.  CMS is making these modifications to the proposed regulations after considering comments received from the December 2014 Notice of Proposed Rulemaking.

“Accountable Care Organizations have shown early but exciting progress in improving quality of care, while providing more patient-centered care at a lower cost,” said CMS Acting Administrator Andy Slavitt.  “The ACO rules today strengthen our ability to reward better care and lay the groundwork for more providers to become successful ACOs.”

The final rule issued today improves the program over the proposed rule in a number of areas, including but not limited to:

  • Creates a new Track 3, based on some of the successful features of the Pioneer ACO Model, which includes higher rates of shared savings, the prospective assignment of beneficiaries, and the opportunity to use new care coordination tools;
  • Streamlines the data sharing between CMS and ACOs, helping ACOs more easily access data on their patients in a secure way for quality improvement and care coordination that can drive critical improvements in beneficiaries’ care;
  • Establishes a waiver of the 3-day stay Skilled Nursing Facility (SNF) rule for beneficiaries that are prospectively assigned to ACOs under Track 3; and
  • Refines the policies for resetting ACO benchmarks to help ensure that the program continues to provide strong incentives for ACOs to improve patient care and generate cost savings, and announces CMS’ intent to propose further improvements to the benchmarking methodology later this year.

The Medicare Shared Savings Program was created by Section 3022 of the Affordable Care Act to promote better health for Medicare fee-for-service beneficiaries by encouraging physicians, hospitals, and other health care providers to improve patient health and experience of care and to reduce growth in costs.  The program is voluntary and accepts applications on an annual basis in which organizations agree to participate for three years.

Over 400 ACOs are participating in the Medicare Shared Savings Program, serving over 7 million beneficiaries. Early results released last November indicated the Medicare Shared Savings Program ACOs starting in the first two years of the program improved quality of care for beneficiaries, as ACOs improved performance in 30 of 33 quality measures.

According to an independent evaluation report released by CMS earlier this month, the Pioneer Accountable Care Organization (ACO) Model generated over $384 million in savings to Medicare over its first two years – an average of approximately $300 per participating beneficiary per year – while continuing to deliver high-quality patient care.  The Pioneer ACO Model is the first that meets the tests to have its elements incorporated into other Medicare programs.

ACOs are a part of the Department’s broader initiative to create a health care system that results in better care, smarter spending, and healthier people. The Administration earlier this year announced the goal of tying 30 percent of Medicare payments to quality and value through alternative payment models, such as ACOs, by 2016 and 50 percent of payments by 2018.

For more information on the Medicare Shared Savings Program, please visit: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html.

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Benistar Emerges as Leader in Retiree Benefits

Benistar Emerges as a Nationwide Leader in Retiree Benefits Administration and Insurance Services

After providing extraordinary service for more than two decades, Benistar has now emerged as the leading organization in the nation for design, installation, and administration of post-65 group retiree medical benefits.

With specialized service in health and related insurance, actuarial, underwriting, claims management, and third-party administrative services, Benistar is now a preferred alternative for retiree benefits administration and insurance services. The company has gained the trust from benefits professionals and Medicare beneficiaries as their retiree benefits service provider of choice by offering much more than just administrative or advisory services. As seen at http://www.benistar.com/, Benistar designs, underwrites, delivers and administers complete welfare benefit solutions.

The benefit experts from Benistar are highly proficient in due diligence, restructuring, benefits liability evaluation, stakeholder assistance, advisor support, and investor services. The company operates an integrated portfolio of service solutions offering a full range of healthcare benefit services including Third Party Administration (TPA Services), Retiree Group Benefits Exchange, Employer Group Waiver Program (EGWP) and Prescription Drug (Rx) products, Reinsurance and Risk Management solutions, and Retiree Member Call Center services. Find out more about Benistar Professionals at https://www.linkedin.com/company/benistar-administrative-services-inc.

  • Retiree liability evaluations, carve-outs, OPEB liability transfers and settlements for medical, Rx, group life, and disability obligations
  • Benefit plan cost containment, reductions and financial recapture strategies
  • Welfare Benefit Plan design, installation, and administration
  • Eligibility, Coordination of Benefits, Subrogation and related Audit services
  • Traditional and specialty risk placement and other voluntary supplemental benefits
  • HSA, HRA, MSA and other account based solutions
  • Plan Sponsor Pre and post-bankruptcy filing solutions

For more information, see more about Benistar at https://www.facebook.com/BenistarInc.

About Benistar:  Benistar was established in 1978 and is a nationwide leader in the design and installation of post-65 retiree medical benefits plans.  The company focuses its efforts on administration of retiree health insurance and prescription drug plans and works with consultants and brokers to provide medical and prescription solutions for companies worldwide.

 

 

For More Information:

Jeff Gordon, Media Director

Benistar Admin Services, Inc.

25 Seir Hill Road

Norwalk, CT 06850

(203) 969-6000

info@benistar.com

http://www.benistar.com

 

Benistar Introduces New Retiree Medical Benefits Plans

Benistar, the nationwide leader in the design, installation and administration of group retiree medical benefits, has just launched a series of new retiree medical benefit plans.

Benistar proudly announces the introduction of their new retiree medical benefit programs. Since the original inception of the company in 1978, Benistar has steadily emerged as a trusted provider of group retiree medical benefits. The company’s primary area of specialization is the administration of employer group retiree medical and prescription drug plans. Benistar provides retiree benefit solutions for publicly and privately-held companies, labor unions, city and county government entities, educational organizations, and religious organizations. To find out more, please visit the official website of Benistar as seen at http://www.benistar.com/.

Benistar’s group retiree medical plans are designed to pay for the costs that are recognized but not covered by Medicare Parts A and B. The experienced and knowledgeable service representatives of the company will assist the plan sponsor in developing a cost effective and sustainable solution for its retirees from design through communication and ongoing service support. The company assists plan members in seamlessly transitioning from current arrangements without the need for enrollment forms or other challenging technology. The company’s efficient Retiree Customer Service Center representatives are available over the phone and in person to help the retirees with all of their benefit needs and questions.

The retiree prescription drug plans from Benistar are tailor-made specifically for groups under Medicare Part D. In collaboration with its national PBM and insurance carrier partners, Benistar is fully compliant with all CMS regulation related to Part D plans that are supported by Benistar.

Benistar Completes Record Year

BENISTAR, one of the nation’s largest administrators of group retiree medical and prescription drug plans, reported its most successful year for new business for the fiscal year ending June 30, 2011.

To open the Press Release in a new window, click here

Sweeping Changes Could Slash Generous Retirement Benefits

Some articles the staff at Benistar think you should read:

New York Faces $200 Billion in Retiree Health Costs

Excerpt: “The daunting size of the health care obligation raises the possibility that localities will be forced at some point to choose between paying their retirees’ medical costs and paying the investors who hold their bonds. Government officials aim to satisfy both groups, and have even made painful cuts in local services when necessary to keep up with both sets of payments.”

(The New York Times; free registration required)

New Ways to Manage Retiree Benefits

Excerpt: “Milliman offers a four-step strategy for managing GASB 45 sticker shock.” (Milliman)

Sweeping Changes Could Slash Generous Retirement Benefits of Former Cincinnati City Employees and Future Retirees

Excerpt: “With the troubled city retirement system struggling to dig out of a $1 billion-plus long-term hole, a new pension board – one on which outside financial experts recently replaced city officials with personal stakes in the decisions – is reviewing changes to lower benefits, raise retirement ages and cap pensions well below the current 90 percent-of-salary ceiling.”

Maryland Panel Recommends Sweeping Retirement Benefit Changes for Public Employees

Excerpt: “Maryland state workers would have to work for 15 years instead of the current five to become eligible for pension or retiree health care benefits, according to new recommendations from a study panel. An Associated Press news report said the Public Employees’ & Retirees’ Benefit Sustainability Commission is also recommending that state employees would have to spend 25 years working for the state, instead of 16 years, to receive the maximum retiree health care premium subsidy and put in 10 years instead of five to become pension vested.” (PLANSPONSOR.COM)

Retirement Benefits Helping Employers Attract and Retain New Workers, Towers Watson Survey …

Retirement benefits — especially defined benefit (DB) programs — are giving employers an added advantage when it comes to attracting and retaining new […]

QUOTATION OF THE QUARTER

“The past cannot be changed. The future is yet in your power.”

Mary Pickford

Health Care Reform Drug Subsidy Deduction

3rd Quarter 2010
Some articles the staff at Benistar think you should read:

AARP Says Brand-Name Drug Prices Up 8% in 2009
Excerpt: “Over the last five years, according to the report . . ., the retail prices for the most popular brand-name drugs increased 41.5 percent, while the consumer price index rose 13.3 percent.”
(The New York Times; free registration required)

Health Care Reform: Elimination of Retiree Drug Subsidy Deduction
Employers that provide retiree prescription drug coverage should analyze the increased future tax liability and the current accounting charges necessary to retain retiree prescription drug coverage, and evaluate the practical and legal risks of eliminating this benefit.

N.Y. Faces $200 Billion in Retiree Health Costs
The cities, counties and authorities of New York have promised more than $200 billion worth of health benefits to their retirees while setting aside almost nothing, putting the public work force on a collision course with the taxpayers who are expected to foot the bill.

Medicare actuary: Reform will cost some seniors
A Medicare official concedes that seniors may have to dig deeper into their wallets next year thanks to the health care law.

Dealing with Medicare Part B and COBRA CoverageGenerally, the Socal Security Act provides that individuals may enroll in Medicare Part B (which covers doctors visits and other outpatient services) when they reach age 65. If they fail to do so during a seven-month initial enrollment period surrounding their 65th birthday,

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Benistar featured in the News

The following article about Benistar appeared in the Stamford Advocate:

http://www.stamfordadvocate.com/business/article/Benistar-moves-to-add-staff-433728.php The Stamford Branch of a national employee health and welfare benefits administrator has moved within the city and is in the process of hiring more staff.