CMS unveils the GENEROUS Model, a bold step to align Medicaid drug prices with what other countries pay. Learn more: https://t.co/LCg58zvVD9

Another successful Red Sox season.

Prevention - avoiding, detecting, and better managing disease, such as through lifestyle changes, is key to healthy living. Learn more in this Key Concept 🔑: https://t.co/x3VtlAUYHT

This CMMI model was extraordinarily successful in every major parameter, including politically.

New findings show that the Part D Senior Savings (PDSS) Model achieved its goals: ⬆️ increasing insulin use and adherence while ⬇️ reducing out-of-pocket costs for people with Medicare. Read more: https://t.co/Z6If8FvTl2

"Jules, this is Brian. Listen, I'm on an airplane that's been hijacked. If things don't go well, and it's not looking good, I just want you to know I absolutely love you. I want you to do good, go have good times. Same to my parents and everybody, and I just totally love you, and

⏰Got a minute? CMS Administrator @DrOzCMS and CMS Innovation Center Director @AbeSutton share how the Cell and Gene Therapy Access (CGT) Model is increasing access to potentially transformative treatments for people with #SickleCellDisease: https://t.co/yXkVrwy523

⏰Got a minute? Learn what’s an “episode of care” and how it’s used to promote stronger collaboration to health care delivery in the TEAM model and other Innovation Center pilot programs: https://t.co/bXMjPm4dmx

Check out Innovation Center Director @AbeSutton on the latest episode of The ACO Show where he talks to @Farzad_MD about the Center’s strategy, WISeR and ASM models, & helping shape the future of health care innovation. Tune in: https://t.co/IH4ZyVpYrA @AledadeACO @dc_cavanaugh

#ICYMI: The newly proposed Ambulatory Specialty Model is designed to promote prevention, upstream management, and timely, targeted care of low back pain and heart failure for people with Medicare. Learn more: https://t.co/SccxjgfaU0

We’re pleased to announce that 33 states, plus the District of Columbia and Puerto Rico will participate in the Cell and Gene Therapy Access Model. Learn more:

#ValueBasedCare focuses on what you value most. #WhatDoYouValue? For this kidney dialysis patient, it was being able to continue working while receiving kidney dialysis. With #HomeDialysis, she was able to do just that: https://t.co/Goh9u0qD3n

But I'm hopeful this highly targeted, technologically innovative approach is the right path forward. /End

But Medicare at its best sets the standard for how health care is paid for. Targeted pre-service review is a necessary part of health insurance whether it is public or private--there are unfortunately bad actors out there billing health insurance. /7

It is voluntary for providers who can elect to have their services reviewed after they are delivered (and risk nonpayment if they were not appropriate.) I know there is suspicion of anything with PA and also regarding any potential threats to Traditional Medicare. /6

The new model is trying to use machine learning/AI to do reviews faster and more reliably. It is limited to a small number of services that are vulnerable to fraud and abuse, including skin substitutes. /5

But that process was manual and slow, taking over a week. So the contractors who administer the process often didn't use it for fear of delaying needed service, contributing to the recent abuse of Medicare to pay for harmful skin substitute surgeries:  https://t.co/Ely9VqnaLd. /4

But there is real risk of unscrupulous providers abusing billing without a function that can intervene before obviously fraudulent services are delivered and claims are filed. And traditional Medicare has had for years some legal ability to review specific services in advance. /3

"Prior authorization" has itself been abused by private insurers and there was a major HHS/CMS announcement last Monday directed toward reining it in:  https://t.co/RHFyGrGWE8. This is a major problem that is hated by physicians and creates major risks for patients. /2

A brief thread on @cmsinnovates new model called WiSER. This model will test a highly targeted and more streamlined approach to payor review of medical services in insurance by trying it in Traditional Medicare. https://t.co/j5PiWboAzm. /1