Medicare

Medicare Premiums, Inflation Create Affordability Challenges

by Kelsey Waddill

Medicare beneficiaries are experiencing healthcare affordability challenges in 2022 due to Medicare Part B premiums and inflation, according to a MedicarePlans.com survey. Pollfish surveyed 1,250...

State, Medicaid Coverage For Obesity Treatments Varies Widely

by Kelsey Waddill

State and Medicaid coverage for obesity treatments is not uniform, despite the epidemic-level impact of the condition and the selection of tested treatment options, according to a report from the Urban...

CMS Updates Medicare Coverage for Certain Lung Cancer Screenings

by Kelsey Waddill

CMS has announced that it will expand the eligibility criteria for a national coverage determination for lung cancer screenings. “Expanding coverage broadens access for lung cancer screening to...

AHIP Comments on Alzheimer’s Drug National Coverage Determination

by Kelsey Waddill

AHIP supported CMS on its national coverage determination for monoclonal antibodies (mAbs) directed against amyloid for treating Alzheimer’s Disease and offered recommendations for clarification...

High Health Insurance Literacy Tied to Medicare Advantage Enrollment

by Victoria Bailey

Medicare beneficiaries with high health insurance literacy were more likely to enroll in Medicare Advantage and select low-cost plans with high Medicare Advantage star ratings, compared to those with...

MACPAC Shares Spending Trends Among Dual Eligible Beneficiaries

by Kelsey Waddill

MACPAC has released data on utilization and healthcare spending trends among dual eligible beneficiaries in calendar year 2019. First, the report assessed dual eligible use of certain Medicare...

Medicare Will Cover OTC Coronavirus Tests At The Counter

by Kelsey Waddill

CMS has announced that Medicare will cover over-the-counter coronavirus tests. Medicare beneficiaries will be able to access free over-the-counter coronavirus tests through covidtests.gov. The tests...

Key Factors Behind How Much Commercial Insurers Pay Providers

by Kelsey Waddill

Commercial payers have been experiencing higher healthcare spending than fee-for-service Medicare due to higher prices, according to a report from the Congressional Budget Office (CBO). CBO observed...

Industry Reacts to CMS Medicare Coverage Determination Proposal

by Kelsey Waddill

Payers are reacting to the CMS proposed Medicare coverage determination for Alzheimer’s treatments that use monoclonal antibodies directed at amyloid, such as Biogen’s...

CMS Releases Medicare Coverage Proposal for Alzheimer’s Treatment

by Kelsey Waddill

Updated 1/12/2022: This article has been updated to correct the drug price for Aduhelm. The article previously cited the drug price as the original price, which was $56,000. However,...

Medicare Coverage Policies Can Result in Millions of Denied Claims

by Kelsey Waddill

The share of denied claims in Medicare is largely attributable to laboratories, according to a study published in Health Affairs. Researchers worked with Aetna and Medicare data to assess the number...

More Medicare Beneficiaries with COPD Enrolled in FFS Than MA

by Victoria Bailey

The majority of Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) are enrolled in fee-for-service Medicare, but the share of beneficiaries in Medicare Advantage plans is...

Medicaid Asset Test Revisions May Increase Dual Eligibility for Seniors

by Victoria Bailey

Adjusting the Medicaid asset test to accurately reflect inflation levels could increase Medicaid eligibility for low-income, elderly, and disabled Medicare beneficiaries, according to a Health Affairs...

Dual Eligible Beneficiaries Prefer Medicare Advantage Over FFS

by Victoria Bailey

Dual eligible beneficiaries were more likely to choose a Medicare Advantage plan over a fee-for-service Medicare plan, a study commissioned by Better Medicare Alliance (BMA) found. To understand the...

The Impact of In-Home Chronic Disease Management on Spending

by Kelsey Waddill

Employing personalized, in-home chronic disease management services can have a significant impact on spending for seniors with chronic conditions, a study from Avalere found. “Demonstrating a...

Few Seniors Have Changed Plans During 2022 Open Enrollment

by Kelsey Waddill

Nearly nine out of every ten American seniors had not changed Medicare plans with less than a month left in the 2022 open enrollment season, according to a MedicareGuide.com survey. MedicareGuide.com...

Biden Plan Expands COVID-19 Testing Coverage, Booster Outreach

by Victoria Bailey

As the weather gets colder and the Omicron variant of the coronavirus emerges in the United States, the Biden administration has released an action plan that included steps to expand COVID-19 testing...

$0 Premium Plans Are Pushing Medicare Advantage Premiums Lower

by Kelsey Waddill

Zero-dollar health plans are bringing average Medicare Advantage premiums lower, continuing an ongoing trend, an eHealth report found.  eHealth surveyed over 4,200 Medicare beneficiaries who were...

Public Payers See Higher Member Satisfaction on Network Size, Cost

by Kelsey Waddill

Medicare Advantage, fee-for-service Medicare, and Medicaid received higher member satisfaction scores than individual health insurance market plans and employer-sponsored health plans, according to a...