A new study found that MA beneficiaries have more than 50% fewer inpatient stays and 22% fewer emergency department visits than traditional Medicare enrollees.

Medicare Advantage beneficiaries with a cancer diagnosis spend $3,996 on out-of-pocket costs and premiums annually, versus $6,091 for traditional Medicare beneficiaries with cancer, a new report found.

Novartis became the seventh drugmaker to legally challenge the White House’s Medicare drug pricing negotiation program. The company filed its lawsuit three days after HHS announced the first 10 drugs that were selected for the program — its heart failure medication Entresto was one on the list. HHS can expect to face more lawsuits from the manufacturers of the 10 drugs it named last week, experts have warned.

HHS released the first 10 drugs selected for the Medicare Drug Price Negotiation Program. These drugs include Eliquis, Jardiance and Xarelto. Under the program, the federal government will be able to negotiate the price for selected drugs for the first time.

A new study found that between 16.2% and 17.7% of Medicare Advantage enrollees reported using post-acute care services, compared to 22.4% to 24.1% of traditional Medicare enrollees.

About 20% of Medicare beneficiaries are “very worried” about the long-term sustainability of Medicare, 54% are “somewhat worried” and 25% are “not at all worried,” according to an eHealth survey.

Only 44% of Medicare Advantage enrollees said they “fully understand” their plan, while 50% said they “somewhat understand” it and 6% said they don’t understand it, according to a recent survey.

Suvida Healthcare — a startup providing primary care for Medicare-eligible Hispanic adults — is adopting Elation Health’s primary care-specific technology platform. The platform comprises an EHR, as well as software for patient engagement, telehealth and revenue cycle management. Suvida’s chief medical officer said Elation beat out the competition due to its focus on both primary care and value-based care.

About 27% of Medicare Advantage enrollees are Black, Latino or Asian, versus 17% of traditional Medicare enrollees, according to a report conducted by ATI Advisory and commissioned by the Better Medicare Alliance.

For breast cancer, 20.5% of patients received a screening in the year prior to being on Medicare, compared to 30.4% in the first year of being on Medicare, according to an Epic Research report. For colorectal cancer, screening rates jumped from 6% in the year before being on Medicare to 11% in the first year of being on Medicare.

The Treat and Reduce Obesity Act would expand Medicare coverage for obesity screenings, treatments and therapies like anti-obesity medications. The Health Equity Coalition for Chronic Disease came out in favor of the bill and asked for swift passage.

On average, Medicare households spent 15% of their total spending on health-related expenses in 2021, versus 7% for non-Medicare households, according to a new KFF report.

Over the past decade, a significant percentage of the country’s physicians have shifted from working in private practices (defined as those owned wholly by physicians) to working in bigger, health system-owned practices. The ability to negotiate higher payment rates with insurers when working at a larger practice is a crucial factor causing this trend, according to a new AMA analysis.

CMS recently revealed its proposals to raise reimbursement rates for hospital outpatient departments and cut payments for physicians. Next year, the agency is planning to decrease physicians’ pay by 1.25% and increase outpatient payment rates by 2.8%. Provider groups are unhappy with the news — AMA President Dr. Jesse Ehrenfeld said the new physician fee schedule will be “almost biblical in its impact.”

The average income of a traditional Medicare enrollee is $85,085, versus $76,720 for a Medicare Advantage enrollee, according to a whitepaper done in partnership between Harvard Medical School and software solutions company Inovalon.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.”

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.

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.