Medicare
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MA Enrollees Less Likely To Be Prescribed High-risk Medications Than Traditional Medicare Enrollees
In 2018, there were 41.5 high-risk medications per 1,000 beneficiaries for Medicare Advantage, compared to 56.9 high-risk medications per 1,000 beneficiaries for traditional Medicare, a new study found.
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Lawsuits Against Medicare Drug Negotiations Are Mounting, But They Probably Won’t Be Able to Stop The Plan
Lawsuits filed in opposition to the White House’s drug pricing negotiation program are beginning to mount, but legal experts agree that the plaintiffs’ arguments probably won’t hold up during a court battle. However, these lawsuits still could delay when the government’s ability to negotiate price goes into effect.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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MedCity Influencers, Opinion, Payers
It’s Not Just Work Requirements; Food Insecurity is a Multidimensional Issue
Twelve short years ago I was a single mother, pregnant and surviving off of food stamps where I relied on the support of the SNAP program. Now, I’ve been given the opportunity to build a platform where I can give a voice to those in similar positions that I once was in and advocate for their needs.
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Primary Care Missed Targets in the Quadruple Aim
Medical schools and residency training programs push trainees away from primary care and make primary care seem less prestigious. Medicare is the largest payer of graduate medical education, so Medicare could require additional outpatient primary care training in residency to encourage Family and Internal Medicine trainees to enter outpatient primary care, where the need is critical.
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Report: Medicare Spending Reached $744B in 2022
A new KFF analysis showed that Medicare spending per person increased to $15,700 in 2022 from $5,800 in 2000, representing a 4.6% average annual growth.
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Why Medicare Should Treat Obesity as a Disease
Medicare is failing its beneficiaries by not treating obesity as a disease. Just like people with high blood pressure often need to take medications to avoid disease-related complications, people with obesity need access to all appropriate, evidence-based therapies to combat the disease.
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Medicare Improperly Paid Providers $348M for Telehealth Psychotherapy Services
Out of the $1 billion in Medicare payments to providers for psychotherapy services in the first year of Covid-19, $580 million were improper payments, an audit by the Office of Inspector General found. This includes $348 million for telehealth services.
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Report: MA Enrollment Increases to Half of All Eligible Medicare Beneficiaries
Out of 59.82 million people with Medicare Part A and Part B in January 2023, 30.19 million people were enrolled in Medicare Advantage plans, the Kaiser Family Foundation found in a recent analysis.
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Medicare, VHA Made $128M in Duplicate Payments, OIG Report Shows
Medicare could have saved $128 million if the Centers for Medicare and Medicaid Services had the correct controls in place to avoid duplicate payments with the Veterans Health Administration, an audit by the Office of Inspector General found.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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Report: More Traditional Medicare Enrollees Are Buying Medicare Supplement Coverage
The share of traditional Medicare enrollees who bought Medicare Supplement coverage rose to 41% in 2021, compared to 35% in 2017, according to a report from America’s Health Insurance Plans. Medicare Supplement enrollees are three times less likely to have issues paying medical bills than those who only have traditional Medicare.
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Consumer / Employer, Health Tech
Zocdoc Adds FQHCs to Marketplace To Support Medicare, Medicaid Beneficiaries
Zocdoc, a healthcare marketplace, is adding Federally Qualified Health Centers (FQHCs) to its platform. Patients are now able to find and book appointments with FQHCs working with Zocdoc on the company’s website or app, and can filter based on factors like specialty and location.
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Oak Street, Interwell Combine Primary Care & Dialysis with New Joint Venture
Oak Street Health teamed up with kidney care management company Interwell Health to create a joint venture called OakWell, which seeks to provide primary care to end-stage kidney disease patients directly in existing dialysis centers. End stage kidney disease patients spend upwards of 12 hours per week in dialysis centers — OakWell is meant to eliminate the barrier of attending separate, additional medical appointments.
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42 Hospitals Sue HHS for ‘Tens of Millions’ of Dollars in Delayed Medicare DSH Payments
Forty-two safety net hospitals recently sued HHS, alleging that the Medicare program “unlawfully withheld and unreasonably denied” DSH payments for decades. The plaintiff hospitals said that HHS’ failure to recalculate DSH payments have cost them “tens of millions of dollars in funds that should have been paid to them many years ago.”
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Pharma, BioPharma, Legal, Payers
HHS Cites 27 Medicare-Covered Drugs Whose Prices Rose Faster Than Inflation
Companies who raised drug prices higher than the rate of inflation must rebate the difference to Medicare, according to a provision of the Inflation Reduction Act. The highest-profile product on the list might be AbbVie’s blockbuster immunology drug Humira.
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Report: Medicare Advantage Enrollment Sees Continued Growth, but at a Slower Rate
Enrollment in Medicare Advantage plans increased by 5.5% this year, or by 1.5 million beneficiaries, according to The Chartis Group. But in 2020, 2021 and 2022, enrollment rose by 1.9 million, 2.2 million and 2.3 million, respectively.
Promoted
Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
Promoted
Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
