The Medicare Payment Advisory Committee (MedPAC) submitted its
March 2023 Report to Congress which included its 2024 payment recommendations for Medicare fee-for-service (FFS), Medicare Advantage (MA) and the Medicare prescription drug program (Part D). This year's report is likely to please no one as the committee took aim at claims of...
While the Centers for Medicare and Medicaid Services (CMS) are moving forward with tighter regulations on the Medicare Advantage (MA) program, the Heritage Foundation argues that freeing MA from the constraints of Medicare Fee-For-Service (FFS) payment rates and making it the default Medicare enrollment system would offer a solution to...
The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released its 2023 data book on dually eligible beneficiaries this week.
Dual-eligible beneficiaries receive Medicare as the primary payer, which covers medical services including physician, inpatient and outpatient care....National News
Last week, the Medicare Payment Advisory Commission (MedPAC) made its recommendations to Congress for Medicare payment rates for hospitals and physicians.
Commissioners made it known that the recommendations were a reflection of the current environment and issues related to the COVID-19 pandemic, but didn't recommend to raise rates...National News
As the national mental health crisis worsens, in part due the COVID-19 pandemic for patients and healthcare workers alike, behavioral healthcare integration is at the top of industry priorities. This week, health care payers of all stripes are innovating solutions to covering costs.
The Medicare Payment Advisory Commission (MedPAC)...National News
Last Friday, the Medicare Payment Advisory Committee (MedPAC) held a public virtual meeting to assess payments for hospice services and make recommendations for updating payments. It determined that it would recommend a 3% cut to Medicare base payments made to skilled nursing facilities (SNFs) in 2024.
The meeting presages the...
Last Thursday, the Kaiser Family Foundation (KFF) published a report demonstrating that Medicare Advantage is poised to represent over half of Medicare beneficiaries as soon as next year. Another report, published simultaneously, showed that over $10 billion has been spent by Medicare on the quality bonus program (QBP) that incentivizes...
This week, the Medicare Payment Advisory Commission (MedPAC), the independent legislative branch agency tasked with analyzing the Medicare program for the purpose of offering insight and advice into the program for policymakers, published its annual Data Book.
The MedPAC Data Book, "Health Care Spending in the Medicare Program," is a...National News
The Medicare Payment Advisory Committee (MedPAC) sent its annual March report to Congress on Medicare fee-for-service (FFS) payment systems, Medicare Advantage (MA) and the Medicare prescription drug program (Part D). The report contains analysis of the COVID-19 pandemic's influence on Medicare spending and the subsequent sustainability...
Following approval by the Food and Drug Administration (FDA) last year, the Centers for Medicare and Medicaid (CMS) proposed last month to cover the Alzheimer’s disease drug Aduhelm only for beneficiaries enrolled in a clinical trial. The proposal has sparked fierce debate among insurance groups, drugmakers, policymakers and the...
The Direct Contracting payment model, devised under President Donald Trump's Center for Medicare and Medicaid Innovation (CMMI), grows more controversial as it has ended up in the crosshairs of Congressional progressives. But some Democrats and industry advocates support the payment model remaining on the table.
Early this month, more...National News
The Medicare Payment Advisory Commission (MedPAC) voted unanimously last Thursday to support a recommendation of no change to the physician fee schedule for 2023. Stakeholders and industry advocates immediately responded with frustration.
In 2020, Medicare paid $64.8 billion to 1.3 million clinicians, which was lower overall than...National News
The Medicare Payment Advisory Commission (MedPAC), the panel that advises Congress on Medicare policy, released new findings last Friday that demonstrate a surge in popularity for the Medicare Advantage program but raises alarms about upcoding practices that have spiked Medicare spending.
Over 50% of Medicare beneficiaries are...National News
Last Thursday, the U.S. Senate voted to delay statutory cuts to Medicare. There were two types of cuts, the first -- 2% -- were delayed until March and relate to Medicare sequestration, which is an automatic reduction of federal spending to enforce a balanced budget. Sequestration of 2% was initially delayed by the Coronavirus Aid,...
Medicare Advantage is under pressure to demonstrate its cost-savings for the Medicare program following a report for the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) that suggests Medicare Advantage (MA) plans "may have inappropriately" leveraged chart reviews and health risk assessments to...
It's just a couple bucks, nonetheless MA plans in 2022 are advertising an average monthly premium of $19, far more than the average MA premium in Arizona at $11.64. But, it all adds up, last year 26.9 million were enrolled in MA nationally; Arizona's MA market enrollment stands at about 636,000, as of Sept. 1, 2021.
National MA...
Spending per beneficiary is growing faster in Medicare Advantage (MA) and private plans than traditional Medicare and Part D prescription drug plans, according to the MedPAC analysis.
Modern Healthcare reports that the spending disparity has experts concerned, considering that Medicare Advantage enrollment is surging, currently...National News
On Tuesday, the U.S. Senate passed President Joe Biden's massive infrastructure bill which proponents say focuses on the administration's key priorities in addition to investment in roads, bridges, airports and waterways, for which $1 trillion was allotted. Immediately after passing with a thin majority, Democrats began discussing budget...National News
This week, the Kaiser Family Foundation released its annual analysis on Medicare Advantage, enrollment and trends for 2021; J.D. Power published its annual U.S. Medicare Advantage study and MedPAC's June report received some criticism from stakeholders.
KFF Analysis
Kaiser's annual analysis of the Medicare Advantage market demonstrated...National News
It's no secret that of all the industries hard hit by COVID-19, skilled nursing and long term care were two of the hardest hit.
A study released on Tuesday by the inspector general of the Department of Health and Human Services found that four in ten Medicare beneficiaries who lived in nursing homes last year had or likely had...
