史蒂夫·沙恩: 大家好，欢迎回来. So, I got a lot of shout outs today, I’m just giving you a heads up right at the beginning. 感谢很多人制作了这个视频, just because they had some good ideas and I’m trying to implement them into today’s video. 首先, thank you to Jerry Freedman for recommending that we put the text down at the bottom for those people who are not listening but are actually just reading along with the video. 诚实, I don’t really understand why you wouldn’t blast the volume on really loud so everybody could enjoy what we have to say here but I guess it’s your prerogative. For you guys that are not listening, you got the text here on the bottom. 谢谢你,杰瑞.
第二名是耶胡达·戴维斯, he mentioned to us a while back about this change and it’s actually going into place. 所以感谢Yehuda的提示, which I’d like to share with everybody else as well if you did not already hear. New York Medicaid used to obviously be working with MLTC plans – managed long-term care plans – so the managed long-term care plans were covering the long-term care patients in the skilled nursing facilities. What’s happening now is that a rule has gone into place that the MLTC plans only need to extend for three months – 90 days – after that a long-term care patient can disenroll from the MLTC plan and revert back to straight Medicaid. 这是正确的, 他们可以直接享受医疗补助, 医疗服务提供者将直接支付医疗补助, communicating with Medicaid directly and the MLTC plans will no longer be covering the resident after three months in the facility. 这对每个人来说都是好消息. It’s good for the providers because providers don’t need to work through a middleman like MLTC. 他们可以直接与医疗补助计划合作. It’s also great for the MTLC plans in a way because they have members of the insurance as a whole and the more complex ones are the ones that are constantly institutionalized, 现在这些成员被除名了, it kind of makes their job easier for the members that they do need to care for. So it sounds like a real win-win but I’m not sure how Medicaid feels about this, 但你知道, it’s going back to how it used to be so I don’t really see a problem with that either.
Now there’s one thing that I’m not sure everybody does know about and that is Medicare’s soul-searching that they’ve been doing recently. 医疗保险制度建立于1965年. 当时, the concept for what Medicare was there for was to provide care for coverage that was “primarily health-related.这是他们的口号, anything that’s “primarily health-related” is what Medicare covered for Medicare recipients. 那是很久以前的事了. What seems to be happening now is that the folks at Medicare got together and they’re scratching their heads and they’re like “This doesn’t seem right. If our coverage is for ‘primarily health-related’ care, we should be covering more.这正是他们正在研究的. 同时还有医疗保险优先计划, 保险计划是什么, 正在取代医疗保险, 也在调查这件事吗. Because if the coverage should be “primarily health-related,” it should really be expanded to more services and more kinds of healthcare settings. So to give you some examples of things that are being speculated; nutritious food, 前往保健服务的交通, 独立生活, 辅助生活, 成人日托, other healthcare settings are now considered for Medicare reimbursement. This is an extremely exciting idea for healthcare providers, this is something that they plan on putting in place in 2019, 哪一个不太远. We’ve actually been in talks with a lot of the national healthcare insurers that are working with us to try to figure out exactly how they can provide services to Medicare members and in what avenues they can now cover. 所以在2019年抓紧吧, we’re expecting that some of these services in some of these avenues will be covered, 但要抓紧, 还没有决定.
So for the last shout out, I want to give a shout out to Seema Verma at CMS. Your tagline is “primarily health-related” for Medicare. 来吧, 你可以做得更好, I’m going to give you two suggestions and whoever is watching this please put in the 评论 any other suggestions you think the Medicare tagline should be. 我相信我们可以利用他们现在的资源做得更好. 下面是我的两个建议, they’re not awesome but it’s a start; Medicare – You Paid Into It, 现在现金. 你喜欢,? How about this one; Medicare – We Keep Your Providers Happy So They Can Keep You Healthy. 正确的? 你喜欢那个，我看你也喜欢那个. 如果你有更好的, 把它写在评论里，我要把它拿走, 把它塞进信封里, 寄给Seema Verma, 希望我们能很快给一些东西注册商标. 当然, 如果你有问题, 评论, 或者任何你认为能让这个视频更好的东西, 请让我们知道，这样我们可以为你做得更好. 当心.