Medicare coverage gaps may cause considerable financial distress for the most seriously ill patients, with 53 percent of seriously ill Medicare beneficiaries admitting they struggle to pay for care,...
On Thursday, President Trump issued the Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors that will authorize the Department of Health & Human Services to expand...
Faced with a unique Medicare landscape going into 2020, Krista Bowers, general manager of senior markets at Blue Shield of California (BSC), and her team created a solution that no other company in the...
Contrary to the negative predictions, Medicare Advantage beneficiaries’ access to care and health plan affordability did not change between 2009 to 2017, according to a recent study published in...
The Office of Inspector General (OIG) audited Medicare spending and found that CMS spent $160.8 million paying for drugs that should have been covered by hospices. This data follows a 2012 OIG report...
As healthcare costs continue to escalate, policymakers have put forth numerous solutions to control Medicare drug spending and, through it, stabilize the healthcare economy, a recent Kaiser Family...
The average basic Medicare Part D premium for prescription drug plans is projected to decline, CMS announced.
“CMS has been taking action to lower the cost of prescription drugs, and we are...
The Senate Finance Committee has passed the Prescription Drug Pricing Reduction Act (PDPRA), a bipartisan piece of legislation that checks pharmacy benefit managers’ practices of overpayment and...
On Thursday, the White House backed down from its proposed rule that would have prohibited pharmacy benefit manager rebates because the rule would have raised seniors’ premiums and Medicare...
A recent Health Affairs study found that some Medicare beneficiaries would pay higher out-of-pocket costs for generic drugs than for specialty or brand-name drugs.
Researchers from Vanderbilt...
People who choose to enroll in Medicare Advantage plans have lower average spending before enrolling in these plans than beneficiaries who choose to stay in traditional Medicare, according to a report...
CMS and HHS have announced the CMS Primary Cares Initiative, a new set of value-based care payment models that will strengthen primary care and deliver better value for patients.
The CMS Primary Cares...
Documentation issues and other errors led to Medicare fee-for-service programs improperly paying $23.2 billion in 2017, a GAO report revealed.
In comparison, Medicaid fee-for-service programs...
Inpatient psychiatric facilities are spending a significant proportion of their average revenue on compliance with basic conditions of participation for Medicare, according to a new report from the...
HHS and the CMS Innovation Center have announced a new payment model for emergency and ambulance services that will enable Medicare fee-for-service beneficiaries to receive quality care with lower...
Hospitals could increase their revenue recovery from Medicare bad debt by as much as ten percent per year by identifying insured patients who are also eligible for Medicaid, according to a recent...
CMS’s Center for Medicare and Medicaid Innovation has launched a new payment model and updated an existing model aimed at helping Medicare Part D and Medicare Advantage plans to lower drug prices...
In light of future research on Medicare Advantage spending compared to Medicare fee-for-service, a trio of researchers writing on the Health Affairs blog see the promise in competitive bidding to drive...
Last year, healthcare spending in the US jumped at an estimated rate of 3.9 percent to $3.5 trillion – or $10,739 per person, according to a new analysis from the Office of the Actuary at the...
Providing extended home health benefits for Medicare beneficiaries is likely to stabilize care costs for public payer programs, according to a new analysis from the Commonwealth Fund.
Researchers from...
