Public Payers News

Healthcare spending is higher in Medicare households, study finds

March 19, 2024 - Healthcare spending is higher in households where Medicare covers all members, a KFF issue brief found. Around 66 million adults receive health insurance coverage through Medicare, including 59 million people over 65 and 7 million adults under 65 with disabilities. Coverage costs for Medicare beneficiaries include monthly premiums, deductibles, and...


Articles

Continuous Medicaid eligibility during PHE improved postpartum coverage

by

The continuous Medicaid eligibility requirement during the COVID-19 public health emergency was associated with increased postpartum Medicaid enrollment and reduced uninsurance, according to a study...

2024 Medicare Advantage premiums remain low and stable

by

The average Medicare Advantage premium has remained low and stable, with many beneficiaries choosing plans with a zero-dollar monthly premium, according to data from eHealth, Inc. eHealth’s...

Medicare Advantage enrollment increased by 1.7 million beneficiaries

by

Medicare Advantage enrollment has increased by 1.7 million beneficiaries since 2023, with for-profit health plans dominating the market, a Chartis report revealed. Among 65.9 million Medicare-eligible...

Few Physicians Participate in Both Medicaid and Marketplace Plans

by

Less than three in ten primary care physicians participating in Medicaid also participated in an average marketplace network, raising concerns about continuity of care for beneficiaries disenrolled...

Utilization Restrictions on Medicare Part D Drugs Increased, Study Finds

by

Utilization restrictions on Medicare Part D drugs, including prior authorization and formulary restrictions, increased over time between 2011 and 2020, according to a Health Affairs study. Pharmacy...

Medicare Advantage Beneficiaries Receive Less Home Healthcare Services

by

Medicare Advantage beneficiaries received shorter and less intensive home healthcare services than those in traditional Medicare, a study published in JAMA Health Forum found. The Medicare home...

MA Payment Reductions May Impact Value of Healthcare for Beneficiaries

by

The proposed 2025 Medicare Advantage Advance Notice would impact the value of healthcare for beneficiaries, resulting in higher costs, according to an analysis from the Berkeley Research Group...

Care Access, Coverage Value Similar in Medicare Advantage and Medicare

by

Coverage and care experiences were generally similar for Medicare Advantage and traditional Medicare beneficiaries, but instances of care delays and health assessments differed, a survey from the...

CareSource Partnership Boosts Access to Substance Use Disorder Treatment

by

CareSource has partnered with CKF Addiction Treatment to improve member access to substance use disorder treatment in Central Kansas. “Our shared commitment to decreasing substance use disorder...

Dental Coverage in Medicare Advantage Plans Varies by Demographic

by

Almost a third of beneficiaries had a Medicare Advantage plan that didn’t offer dental coverage in 2019, but coverage was more common among historically underserved populations, a study published...

HHS Will Provide Technical Assistance to States Addressing Homelessness

by

The Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD) are increasing access to federal programs and resources that address homelessness in eight...

How Do Payers Cover COVID-19 Vaccines, Treatments, and Tests Post-PHE?

by

After the public health emergency (PHE) ended, many federal regulations that facilitated access to COVID-19 vaccines, treatments, and tests expired. While some policies may still apply, coverage...

Medicare Part D Low-Income Subsidy Loss Tied to Higher Out-of-Pocket Costs

by

Beneficiaries who temporarily lost their Medicare Part D low-income subsidy experienced higher out-of-pocket drug costs and fewer prescription fills, a study published in JAMA Health Forum...

HCSC Announces $3.3B Cigna Medicare Business Acquisition

by

HCSC, an independent licensee of the Blue Cross Blue Shield Association, intends to seal the acquisition of Cigna’s Medicare businesses for $3.3 billion, the payer announced. The purchase...

Lawmakers Lobby for Payment and Policy Stability in Medicare Advantage

by

A bipartisan group of United States Senators has urged CMS to ensure payment and policy stability in Medicare Advantage as the agency considers program updates for 2025. The letter to CMS...

CMS Proposes 3.7% Increase in Medicare Advantage Plan Payments

by

Medicare Advantage plan payments will increase by 3.7 percent or $16 billion in 2025, CMS proposed in the Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage and Medicare Part D...

HHS Seeks Stakeholder Input to Improve Medicare Advantage Transparency

by

HHS has issued a request for information (RFI) to help improve data-sharing and transparency in the Medicare Advantage. Over half of all Medicare beneficiaries are enrolled in Medicare Advantage,...

Underserved MA Beneficiaries Opt for Plans with Supplemental Benefits

by

Black Medicare Advantage beneficiaries and those with lower income or educational attainment were more likely to choose health plans that include supplement benefits, such as dental and vision...

CMS Finalizes Payer Requirements to Streamline Prior Authorization

by

CMS has finalized requirements for payers to streamline the prior authorization process and improve the electronic exchange of health information to help limit patient care disruptions. The CMS...