Guest post: Congress shouldn’t put future innovation at risk
Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The […]
Medicare
Quality of Care at Teaching Hospitals
Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard […]
Florida Sen. Rick Scott Off Base in Claim That Rise in Medicare Premiums Is Due to Inflation
An increase in Medicare Part B premiums means “America’s Seniors Are Paying the Price for Biden’s Inflation Crisis” — The headline of a press release […]
Impact of biosimilar entry on drug costs
While generic drugs frequently replace their branded counterparts after the latter lose their market exclusivity, the uptake of biosimilar products is often slower. Further, biosimilars […]
Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act
As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader […]
What’s missing in the current drug pricing plan
Last week, a congressional forum looked at the role pharmacy benefit managers (PBMs) play in determining what patients pay out of pocket for prescription medicines. […]
Explaining the Prescription Drug Provisions in the Build Back Better Act
The Build Back Better Act includes several provisions that would lower prescription drug costs for people with Medicare and private insurance and reduce drug spending […]
Inflation and Retirement: How to Protect Your Savings
With prices rising at their fastest rate in decades, people in retirement or approaching it should take extra care to protect their savings.
Inflation and Retirement: How to Protect Your Savings
With prices rising at their fastest rate in decades, people in retirement or approaching it should take extra care to protect their savings.
Inflation and Retirement: How to Protect Your Savings
With prices rising at their fastest rate in decades, people in retirement or approaching it should take extra care to protect their savings.
ICYMI: PhRMA CEO speaks at STAT Summit about government price setting
As part of the annual STAT Summit, PhRMA President and CEO Stephen J. Ubl recently spoke with STAT’s Matthew Herper to discuss the many unintended […]
Inflation and Retirement: How to Protect Your Savings
With prices rising at their fastest rate in decades, people in retirement or approaching it should take extra care to protect their savings.
KHN’s ‘What the Health?’: Boosting Confusion
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
EasyHealth Secures $135M to Redesign Medicare Experience
What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best […]
Three things to know about so-called Medicare “negotiation” polling
As policymakers continue to push partisan drug pricing proposals, several polls misrepresenting voter opinion have been circulated to try and justify these flawed policies. These […]
Did the Oncology Care Model produce cost savings?
The answer is ‘yes’, but the magnitude of these savings are relatively small and more than offset by additional OCM program costs. Keating et al. […]
Biogen’s Alzheimer’s drug is unlikely to win E.U. approval.
The drug, Aduhelm, has been mired in controversy since it was in approved in the United States in June.
Biogen’s Alzheimer’s drug is unlikely to win E.U. approval.
The drug, Aduhelm, has been mired in controversy since it was in approved in the United States in June.
Biogen’s Alzheimer’s drug is unlikely to win E.U. approval.
The drug, Aduhelm, has been mired in controversy since it was in approved in the United States in June.
Biogen’s Alzheimer’s drug is unlikely to win E.U. approval.
The drug, Aduhelm, has been mired in controversy since it was in approved in the United States in June.
Key Questions About the New COVID-19 Vaccination Requirement for Health Care Provider Staff
On November 5, 2021, the Centers for Medicare and Medicaid Services (CMS) published regulations that establish the first ever federal vaccination requirements for health care […]
Medicare Part B premiums to see big hike next year
CMS cited rising drug costs and the Covid-19 pandemic as the reason for the premium increases, which will rise to $170 in 2022 for people […]
In the current health care debate, Congress has lost sight of what matters to U.S. voters
For months Congress has been debating massive changes to the nation’s social safety net, one of which is the highly popular Medicare prescription drug benefit. […]
Journalists Offer Primers on Medicare Open Enrollment and Death Benefits Amid Covid
KHN contributing writer and former columnist Michelle Andrews discussed on Newsy on Tuesday how unvaccinated workers risk losing the death benefits they would have otherwise […]
CMS scraps coverage rule for breakthrough devices
The agency decided to rescind a rule by the previous administration where Medicare would be required to cover breakthrough devices for up to four years […]
Making medicines more affordable: Modernizing Medicare
Common-sense reforms can help ensure everyone benefits from America’s engine of innovation and receives the care they need and deserve. In this series, we’re taking a closer […]
La inscripción de Medicare es temporada abierta para estafadores
Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. […]
KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Researcher: Medicare Advantage Plans Costing Billions More Than They Should
Switching seniors to Medicare Advantage plans has cost taxpayers tens of billions of dollars more than keeping them in original Medicare, a cost that has […]
Medicare’s Open Enrollment Is Open Season for Scammers
Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. […]
Oak Street Health stock drops on DOJ investigation
In its earnings statement, the company disclosed that it received a civil investigative demand from the Department of Justice. Specifically, the agency was looking for […]
Medicare prices AI-based screening for diabetic retinopathy
The agency set a national payment amount for AI-based screenings for diabetic retinopathy in its 2022 Medicare Physician Fee Schedule final rule. It would also […]
Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap
Medicare’s annual open-enrollment season is here and millions of beneficiaries — prompted by a massive advertising campaign and aided by a detailed federal website — […]
New PDGM Adjustments Make It Tougher to Reach ‘Medium’ or ‘High’ Functional-Impairment Levels
Home health operators have to navigate numerous regulatory and policy changes to stay in business. Two major ones surfaced within days of each other last […]
Democrats Choosing Less Risky Path on Drug Prices
Experts say recent compromises could create less harm in balancing innovation with profits.
Democrats Choosing Less Risky Path on Drug Prices
Experts say recent compromises could create less harm in balancing innovation with profits.
Democrats Choosing Less Risky Path on Drug Prices
Experts say recent compromises could create less harm in balancing innovation with profits.
Democrats Choosing Less Risky Path on Drug Prices
Experts say recent compromises could create less harm in balancing innovation with profits.
Final Rule Gives Home Health Agencies Breathing Room for HHVBP, Medicare Sequestration
Now that the final home health payment rule for 2022 has been floating around for a few days, industry insiders have had time to pick […]
Democrats Reach Deal to Control Drug Prices in Bill
The provision would, for the first time, allow the government to negotiate prices for some medicines covered by Medicare.
Democrats Reach Deal to Control Drug Prices in Bill
The provision would, for the first time, allow the government to negotiate prices for some medicines covered by Medicare.
Despite Restraints, Democrats’ Drug Pricing Plan Could Still Aid Consumers
The Medicare prescription drug pricing plan Democrats unveiled this week is not nearly as ambitious as many lawmakers sought, but they and drug policy experts say the […]
Democrats Plan to Expand Medicare Hearing Benefits. What Can Consumers Expect?
President Joe Biden’s mammoth domestic spending bill would add hearing benefits to the traditional Medicare program — one of three major new benefits Democrats had […]
KHN’s ‘What the Health?’: Compromise Is Coming — Maybe
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Few Acute Care Hospitals Escaped Readmissions Penalties
Preventable rehospitalization of the nation’s older adults has proved a persistent health and financial challenge for the U.S., costing Medicare hundreds of millions of dollars […]
What they are saying: Government price setting for medicines is not the answer
America’s biopharmaceutical companies continue to voice the dangers of current proposals in Washington that would allow the government to set prices for medicines. While it’s […]
Democrats agree last-ditch deal to save drug pricing plans
Under fire for abandoning a plan to allow Medicare to negotiate drug pricing, Democrats in the Senate have reached an agreement that could see the […]
A State Roadmap To Successfully Deploy Medicare Modularity (MMIS)
Victor Sterling, Principal Industry Consultant at SAS In 2010, the Affordable Care Act ushered in a new era for Medicaid Modularity, an approach anchored by […]
CMS extends telehealth coverage for behavioral health in 2022 physician fee schedule
The Centers for Medicare and Medicaid Services dropped its physician fee schedule for next year. It would bolster coverage of telehealth visits for behavioral health […]
Democrats Reach Deal to Control Drug Prices in Bill
The provision would, for the first time, allow the government to negotiate prices for some medicines covered by Medicare.
A Record 3,834 Medicare Advantage Plans Will be Available in 2022, Up 8 Percent From 2021, While the Number of Medicare Part D Stand-Alone Plans is Decreasing Mainly Due to Firm Consolidations
A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s […]
Medicare Advantage 2022 Spotlight: First Look
For 2022, the average Medicare beneficiary has access to 39 Medicare Advantage plans, the largest number of options available in the last decade, and can […]
Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2022
This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. […]
Democrats Reach Deal to Control Drug Prices in Social Policy Bill
The provision would, for the first time, allow the government to negotiate prices for some medicines covered by Medicare.
On behavioral change, health and age
A Health Affairs article (Meyer 2021) discusses the potential benefits of Medicare Diabetes Prevention Programs (MDPP). MDPP aims to reduce patient weight and prevent patients […]
Manchin Raises Doubts on Safety Net Bill, Complicating Path to Quick Vote
Senator Joe Manchin III of West Virginia, a crucial Democratic swing vote, demanded more time to evaluate the economic and fiscal impact of the $1.85 […]
Manchin Raises Doubts on Safety Net Bill, Complicating Path to Quick Vote
Senator Joe Manchin III of West Virginia, a crucial Democratic swing vote, demanded more time to evaluate the economic and fiscal impact of the $1.85 […]
Manchin Raises Doubts on Safety Net Bill, Complicating Path to Quick Vote
Senator Joe Manchin III of West Virginia, a crucial Democratic swing vote, demanded more time to evaluate the economic and fiscal impact of the $1.85 […]
Manchin Raises Doubts on Safety Net Bill, Complicating Path to Quick Vote
Senator Joe Manchin III of West Virginia, a crucial Democratic swing vote, demanded more time to evaluate the economic and fiscal impact of the $1.85 […]
Why Aren’t More People Comparison Shopping for Health Plans?
Most Medicare beneficiaries don’t compare plans during open enrollment season, and may be paying more, or accepting more restrictions, than they should.
Why Aren’t More People Comparison Shopping for Health Plans?
Most Medicare beneficiaries don’t compare plans during open enrollment season, and may be paying more, or accepting more restrictions, than they should.
Journalists Explore Shadow Pandemics of Hospital Violence and Grieving Children
KHN Midwest correspondent Bram Sable-Smith discussed how the pandemic has exacerbated violence in hospitals on Wisconsin Public Radio’s “The Morning Show” on Wednesday. Click here […]
If Congress adds dental coverage to Medicare, should all seniors get it?
William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told […]
What’s Scarier Than Covid? Halloween Health Haikus
Boo that we couldn’t treat all the readers participating in our third annual KHN Halloween Haiku Contest to their moment of gory glory. Your entries […]
This May Be Democrats’ Best Chance to Lower Drug Prices
For patients with certain cancers, out-of-pocket spending can exceed $15,000 a year. Legislation could take aim at prices and the amounts Medicare patients are charged.
Medicare Punishes 2,499 Hospitals for High Readmissions
The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s […]
Democrats’ Plans to Expand Medicare Benefits Put Pinch on Advantage Plans’ Funding
“Did you think we wouldn’t notice?” an older woman says, speaking into the camera. “You thought you could sneak this through?” an older man later […]
Look Up Your Hospital: Is It Being Penalized By Medicare?
Under programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with […]
This May Be Democrats’ Best Chance to Lower Drug Prices
For patients with certain cancers, out-of-pocket spending can exceed $15,000 a year. Legislation could take aim at prices and the amounts Medicare patients are charged.
Potential Costs and Impact of Health Provisions in the Build Back Better Act
A summary of 10 of the major health coverage and financing provisions of the original Build Back Better Act, with discussion of the potential implications […]
Biden and Democrats Push for Budget Deal This Week as Rifts Remain
Negotiators were closing in on a deal that could spend around $1.75 trillion, but lawmakers were still haggling over critical disagreements on the sprawling social […]
3 States Limit Nursing Home Profits in Bid to Improve Care
Nursing homes receive billions of taxpayers’ dollars every year to care for chronically ill frail elders, but until now, there was no guarantee that’s how […]
Part D Senior Savings Model: What is it?
If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? […]
CMMI and its revised strategy
Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been […]
Democrats’ Campaign to Control Drug Prices Nears Collapse
Democrats have made giving government the power to negotiate drug prices a central campaign theme for decades. With the power to make it happen, they […]
Democrats’ Campaign to Control Drug Prices Nears Collapse
Democrats have made giving government the power to negotiate drug prices a central campaign theme for decades. With the power to make it happen, they […]
Sales of Biogen’s Alzheimer’s Drug Fall Short of Expectations
The drug, Aduhelm, brought in $300,000 in revenue in its first full three months of availability. The company expects the drug to generate minimal revenue […]
Sales of Biogen’s costly new Alzheimer’s drug fall far short of expectations.
The drug, Aduhelm, brought in $300,000 in revenue in its first full three months of availability. The company expects the drug to generate minimal revenue […]
Ask About Adherence: CMS finds medication adherence saved Medicare up to $46.6B in avoided health care costs between 2013 and 2018
A recent Centers for Medicare & Medicaid Services (CMS) study found that medication use is improving among seniors and vulnerable beneficiary populations. Better adherence to medicines used […]
[Updated] CMS Getting Closer to Vaccination Guidance for Home Health Agencies, Other Medicare-Medicaid Providers
The Centers for Medicare & Medicaid Services (CMS) revealed last week that it was in the rulemaking stage of a collaboration with the Occupational Safety […]
ICYMI: New study confirms policies like H.R. 3 could significantly reduce drug development
A new study from economists at the University of Chicago examined the impact that government price-setting policies for medicines, like those in H.R. 3, could […]
Watch: Going Beyond the Script of ‘Dopesick’ and America’s Real-Life Opioid Crisis
KHN and policy colleagues at our parent organization KFF teamed up with Hulu for a discussion of America’s opioid crisis, following the Oct. 13 premiere […]
New poll shows Americans reject Medicare “negotiation” once they learn more about the policy
As the debate in Washington around drug pricing proposals continues to intensify, a new Ipsos/PhRMA poll shows Medicare “negotiation” is not nearly as popular as […]
Seven in Ten Medicare Beneficiaries Did Not Compare Plans During Past Open Enrollment Period
This analysis builds on our prior KFF work to examine the share of Medicare beneficiaries who compared plans during the 2018 open enrollment period for […]
An Overview of the Medicare Part D Prescription Drug Benefit
This fact sheet includes the latest information and data about the Medicare Part D prescription drug benefit, including current plan information, the standard benefit parameters, […]
What is Kaiser Family Foundation up to?
For years, Kaiser Family Foundation (Kaiser) has reminded lawmakers that Americans are opposed to government “negotiation” in drug pricing should it lead to less access […]
Bamboo Health ACOs Generate $1B+ in Medicare Shared Savings Program
What You Should Know: – Following the National Association of Accountable Care Organizations (ACOs) announcement of 2020 data detailing the Medicare Shared Savings Program (MSSP), […]
The Public Weighs In On Medicare Drug Negotiations
This data note from the latest KFF Health Tracking Poll explores the public’s views on Medicare drug price negotiation, including how arguments on both sides […]
Large Majorities Across Parties Favor Allowing the Federal Government to Negotiate Drug Prices, Even After Hearing Common Arguments About It
Most of the Public Lacks Confidence that President Biden, Congressional Democrats or Republicans Will Do the Right Thing on Drug Prices Allowing the federal government […]
The Public Backs Medicare Rx Price Negotiation Even After Hearing Both Sides’ Views
As Congress debates cutting prescription drug costs, a poll released Tuesday found the vast majority of adults — regardless of their political party or age […]
Drug Price Negotiation Doesn’t Mean the Government Will Restrict Access to Medicines
This policy watch evaluates the pharmaceutical industry’s claims that allowing the federal government to negotiate drug prices would restrict access to medications in Medicare. It […]
GAO Report on MIPS
The Government Accountability Office (GAO) last week published a report evaluating the Merit-based Incentive Payment System (MIPS). MIPS is an approach for CMS to pay […]
Mandatory Vaccines for Health Care Workers Might Upend Nurses’ Training
Kaitlyn Hevner expects to complete a 15-month accelerated nursing program at the University of North Florida in Jacksonville in December. For her clinical training this […]
An Ad’s Charge That Price Haggling Would ‘Swipe $500 Billion From Medicare’ Is Incorrect
“These guys [insurance companies and Washington bureaucrats] are working together to swipe $500 billion from Medicare to pay for Pelosi and Schumer’s out-of-control spending spree.” […]
KHN’s ‘What the Health?’: The Autumn of Democrats’ Discontent
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Industry leaders discuss the impact of the drug pricing debate
This month, PhRMA hosted a media briefing with leaders within the biopharmaceutical industry to discuss the dangers of current proposals on government price setting, while also sharing alternative solutions that […]
InnovAge CEO Maureen Hewitt: PACE Tailwinds Stronger Than Ever
InnovAge (Nasdaq: INNV) went public earlier this year with a $350 million IPO. It has since set its sights on expansion. The largest Program of […]
Five reasons tying VA prices to Medicare Part D misses the mark
Some members of Congress are considering a government “negotiation” plan that would tie medicine prices in Medicare to those in the U.S. Department of Veterans […]
Many Medicare Beneficiaries Face High Out-of-Pocket Costs for Dental and Hearing Care, Whether in Traditional Medicare or Medicare Advantage
Many Medicare beneficiaries face high annual out-of-pocket costs for dental and hearing care — services that generally aren’t covered in traditional Medicare, but typically are […]
Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage
This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and […]
Increasing LTSS Access Could Cost Up to $12.8 Billion Per Year
Access to long-term services and supports (LTSS) in the U.S. remains limited, which currently puts seniors in need in a bind. Their options are often […]
Dentistas eliminan los problemas de las personas sin seguro ofreciéndoles ellos mismos planes
David White, dentista de Nevada, ha visto dientes enfermos y podridos en la boca de pacientes que habitualmente posponen sus chequeos y evitan procedimientos menores […]
Why Senior-Focused Primary Care Centers Are Reaching into the Home
More and more primary care centers have chosen to specialize in serving seniors. In particular, companies such as CareMax Inc. (Nasdaq: CMAX), VillageMD and Humana […]
Abbott seeks expanded indication, national coverage for CardioMEMS device
With the results of a recent trial Abbott is seeking an expanded indication from the FDA for its CardioMEMS device, intended to prevent hospitalization of […]
Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans
Nevada dentist David White has seen diseased and rotted teeth in the mouths of patients who routinely put off checkups and avoided minor procedures such […]
KHN’s ‘What the Health?’: Much Ado About Drug Prices
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congressional Democrats are […]
America’s biopharmaceutical companies to Congress: Government “negotiation” is the wrong approach
Today, PhRMA member companies made public an open letter to Capitol Hill to encourage Congress to abandon old partisan ideas on drug pricing and instead […]
CMS wants to repeal breakthrough device coverage rule, dashing med device industry hopes
After pushing back the start date twice, CMS now wants to scrap the Trump-era rule, which provides an expedited pathway to Medicare coverage for devices […]
Older Americans Overwhelmingly Support Choose Home Care Act
The vast majority of older Americans want to age in place, several past surveys have found. Unsurprisingly, that desire has translated into overwhelming support for […]
Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage
Despite a pandemic-fueled recession, the number of uninsured Americans has increased only slightly since 2018, according to Census Bureau health insurance data released Tuesday. Twenty-eight […]
Phony Diagnoses Hide High Rates of Drugging at Nursing Homes
At least 21 percent of nursing home residents are on antipsychotic drugs, a Times investigation found.
Justice Department Targets Data Mining in Medicare Advantage Fraud Case
The Justice Department has accused an upstate New York health insurance plan for seniors and its medical analytics company of cheating the government out of […]
Biden Administration Goes Bigger on Cutting Drug Prices
The administration endorses a proposal for the government to negotiate on prices for all U.S. purchasers, not just Medicare.
Potential Savings for Medicare Part D Enrollees Under Proposals to Add a Hard Cap on Out-of-Pocket Spending
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is […]
Biden Administration Goes Bigger on Cutting Drug Prices
The administration endorses a proposal for the government to negotiate on prices for all U.S. purchasers, not just Medicare.
Biden Administration Goes Bigger on Cutting Drug Prices
The administration endorses a proposal for the government to negotiate on prices for all U.S. purchasers, not just Medicare.
2021 Medicare Trustees Report
The 2021 Medicare Trustees Report–formerly known as the “Annual Report of the Boards of Trustees of the Federal Hospital Insurance Trust Fund and the Federal […]
Report: Medicare trust fund still expected to run out by 2026
The latest report from the Medicare Board of Trustees shows that the health insurance trust fund, also known as Medicare Part A, will run out […]
Ochsner Health Launches Fall Prevention Pilot Program to Medicare Advantage Members
What You Should Know: – Ochsner Health and innovationOchsner (iO) have partnered with Bold, an evidence-based, digital exercise platform for older adults aimed at reducing […]
Recent polling misrepresents public support for Medicare “negotiation”
Proponents of government price setting often misrepresent voters’ opinions on support for allowing the federal government to “negotiate” drug prices. This includes recent polling from […]
How CommonSpirit Reduced Medicare Spending by $136M
CommonSpirit Health carved out $136 million in savings to Medicare for 2020, while also improving overall outcomes for hundreds of thousands of beneficiaries, the company […]
Apple, Bose and Others Pump Up the Volume on Hearing Aid Options, Filling Void Left by FDA
Spurred by decades of complaints about the high cost of hearing aids, Congress passed a law in 2017 to allow over-the-counter sales, with hopes it […]
What they’re saying: Patient advocates want to protect Medicare from government interference
For seniors and people with disabilities, Medicare Parts B and D provide important access to lifesaving medicines. Unfortunately, some in Congress are proposing changes to […]
CMS offers additional Medicare payments for at-home Covid-19 vaccinations
Now, Covid-19 vaccine administrators can earn an additional $35 per vaccination for up to five Medicare beneficiaries who live in a communal living space, like […]
Impact of Medicare Pay-for-Performance Program for Surgical Procedures on Cost and Outcomes
In 2008, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Conditions Present on Admission (HAC-POA) program. The goal of this program was […]
Readers and Tweeters Ponder Vaccines and Points of Fairness
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. Higher […]
That $56,000 Drug? Blame Medicare.
For an increasingly important set of drugs, Medicare has been driving up prices. It knows how to do better.
That $56,000 Drug? Blame Medicare.
For an increasingly important set of drugs, Medicare has been driving up prices. It knows how to do better.
Biden’s No-Jab-No-Job Order Creates Quandary for Nursing Homes
President Joe Biden’s edict that nursing homes must ensure their workers are vaccinated against covid-19 presents a challenge for an industry struggling to entice its […]
KHN’s ‘What the Health?’: Booster Time
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Study: Private consultancies can influence hospital participation in CMS bundled payments model
Partnering with private consulting firms can spur greater hospital participation in the Bundled Payments for Care Improvement initiative Advanced Model, in which hospitals earn rewards […]
Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019
The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap […]
Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges
This analysis finds that Medicare spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had instead been coverage by […]
Biden Presses Congress to Act on Prescription Drug Prices
President Biden singled out drug prices as an issue he wanted to include in the Democrats’ $3.5 trillion social policy bill, including allowing Medicare to […]
KHN’s ‘What the Health?’: The Senate Acts
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Biden Presses Congress to Act on Prescription Drug Prices
President Biden singled out drug prices as an issue he wants included in the Democrats’ $3.5 trillion social policy bill, including allowing Medicare to negotiate […]
Myth vs. fact: Polling and Medicare “negotiation”
As some in Washington consider legislation related to prescription medicines and how to best help Americans manage health care costs, government “negotiation” of prescription medicines […]
How Would Drug Price Negotiation Affect Medicare Part D Premiums?
Proposals to allow the federal government to negotiate prescription drug prices, such as H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, aim […]
US telemedicine company owner charged with $784m fraud
A jury in the US has charged a Florida man who owns multiple telemedicine companies in connection with a massive healthcare scam that involved a […]
Why Doesn’t Medicare Cover Services So Many Seniors Need?
Sorry, Joe Namath. Despite what you keep saying in those TV ads, under Medicare, seniors are not “entitled to eliminate copays and get dental care, […]
What will happen with CMS’ policy to cover breakthrough medical devices?
One of many sweeping regulatory changes made in the last year, a rule for CMS to cover breakthrough devices that have been approved by the […]
CMS proposes revoking ‘Most Favored Nation’ drug pricing model
Following several legal battles and opposition from providers, CMS is proposing nixing the Most Favored Nation Model, which matches payments for Medicare Part B drugs […]
2+2=? Senate Uses Murky Math as It Shelves Drug Pricing Rule to Fund Infrastructure
The Senate’s release of its bipartisan infrastructure plan signals that lawmakers are poised to throw former President Donald Trump’s belated bid to lower Medicare drug […]
ICYMI: Event spotlights how we can make Medicare work better for patients
Last month, PhRMA sponsored “Making Medicare Work Better for Patients,” an event hosted by The Hill. During the event, policymakers, patient advocates and biopharmaceutical leaders […]
Celebrating Medicare’s 56th anniversary
For 56 years, Medicare has helped pay for medical care for Americans over the age of 65, as well as younger Americans with certain medical […]
Pfizer Court Fight Could Legalize Medicare Copays and Unleash ‘Gold Rush’ in Sales
Three years ago, pharma giant Pfizer paid $24 million to settle federal allegations that it was paying kickbacks and inflating sales by reimbursing Medicare patients […]
Medicare vaccine coverage (including how the COVID-19 vaccines are covered)
How does Medicare cover vaccines? Are the paid for by Medicare Part B or Part D? MedPAC’s June 2021 report provides a nice overview. Medicare […]
Medicare Enrollment Starting to Accelerate, as Number of Home Health Agencies Continues to Decline
Enrollment in fee-for-service (FFS) Medicare has started to accelerate in recent years, as more members of the baby-boom generation age into the program. At the […]
10 FAQs on Prescription Drug Importation
These FAQs discuss recent efforts related to prescription drug importation, the history of this approach, challenges that previous efforts to carry out importation proposals have […]
Medicare navigation platform Connie Health raises $13M in Series A round
The company — which has raised $16 million in total since its inception in 2019 — will use the new funds to enhance its health […]
Lacking Dental Coverage, Many People on Medicare Forgo Dental Care, Especially Beneficiaries of Color
Many people enrolled in Medicare go without dental care, especially beneficiaries of color, according to a new KFF analysis of dental coverage and costs for […]
Medicare and Dental Coverage: A Closer Look
Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other […]
Success at a glance: Turning incomplete patient data from COVID-19 testing and vaccinations into valid reimbursable claims
“Experian Health’s speed and ability to speak our business language definitely impressed us,” said ACS president, Tim Anderson. “Some of the claims were valid for […]
Despite Formidable Challenges, PACE Leaders Keep Expansion Dreams Alive
The Program of All-Inclusive Care for the Elderly (PACE) concept has gained significant business and policy momentum over the past several months, with recent research […]
Government “negotiation” could have devastating consequences for Medicare enrollees
Some members of Congress are considering significant changes to Medicare that could have a devastating effect on millions of Americans. Proponents call these changes government […]
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Costs High Enough to Exceed the Catastrophic Threshold Over Time
Nearly 3 million Medicare Part D enrollees had out-of-pocket drug spending above the catastrophic threshold in a recent five-year period, finds a new KFF analysis […]
What’s the Latest on Medicare Drug Price Negotiations?
In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price […]
Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on […]
Biogen’s Aduhelm Sales Total $2 Million in Second Quarter
The drug from Biogen, called Aduhelm, is expected to generate billions in sales. It could also strain Medicare’s budget within a few years.
Biogen’s Aduhelm Sales Total $2 Million in Second Quarter
The drug from Biogen, called Aduhelm, is expected to generate billions in sales. It could also strain Medicare’s budget within a few years.
Protecting Medicare from government interference
For more than a decade, Medicare Part D has provided seniors and people with disabilities with affordable and comprehensive prescription medicine coverage. Several surveys show […]
Though Millions Are at Risk for Diabetes, Medicare Struggles to Expand Prevention Program
Damon Diessner tried for years to slim down from his weight of more than 400 pounds, partly because his size embarrassed his wife but even […]
Sen. Wyden: $3.5T Budget May Have to Trim but It Can Set a Path to ‘Ambitious Goals’
Exactly what American health care will look like if Democrats can pass their $3.5 trillion spending plan is unclear, but the senator negotiating its health-related […]
California Makes It Easier for Low-Income Residents to Get and Keep Free Health Coverage
SACRAMENTO, Calif. — Getting clean drinking water cost Ignacio Padilla his health insurance. The World War II veteran needed to repay the loan for the […]
Report: Federal agencies fighting healthcare fraud recouped $3.1B in 2020
Spearheaded by the Departments of Justice, and Health and Human Services, efforts to investigate and prosecute healthcare fraud resulted in the government recovering billions, including […]
Data shows voters strongly support protecting access to their medicines
In our current health care system, the Medicare Part D program helps ensure seniors and people with disabilities have access to the prescription medicines they […]
KHN’s ‘What the Health?’: Here Comes Reconciliation
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Senate Democrats’ Plan Boosts Spending on Medicare, ACA Subsidies, Long-Term Care
The budget package Democrats are assembling in Congress would likely provide the biggest jolt to the American health care system since the passage of the […]
CMS proposes to cover mental health virtual visits through 2022
In the 1,747-page rule, which will be finalized later this year, CMS proposes expanding access to telehealth for behavioral healthcare, including for the first time […]
As Congress Wrestles With Plans to Expand Medicare, Becerra Says Any One Will Do
The Biden administration will support whatever expansions to Medicare Congress is willing to make, Health and Human Services Secretary Xavier Becerra said Tuesday. Democratic lawmakers […]
KHN’s ‘What the Health?’: Becerra Urges Congress to Expand Medicare, Address Rx Prices
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
CMS considers coverage of Biogen’s costly new Alzheimer’s drug
CMS plans to review and determine coverage for Biogen’s Aduhelm, the first new Alzheimer’s disease treatment in decades. But the jury is still out on […]
US starts review of Aduhelm coverage amid fears of Medicare hit
The US government has started a review of how Biogen and Eisai’s pricey new Alzheimer’s disease therapy Aduhelm will be covered by Medicare, to see […]
Drugmakers’ Spending on Stock, Dividends and Executive Pay Exceeds Research, Democrats Say
The largest drug companies are far more interested in enriching themselves and investors than in developing new drugs, according to a House committee report released […]
MedPAC report on alternative payment models
In 2021, CMS expects to operate 12 alternative payment models (APMs) offering 25 distinct tracks for providers to choose from that involve different payment options […]
Paying Billions for Controversial Alzheimer’s Drug? How About Funding This Instead?
If you could invest $56 billion each year in improving health care for older adults, how would you spend it? On a hugely expensive medication […]
Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone’s Guess.
A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use. Long […]
KHN’s ‘What the Health?’: Un-Trumping the ACA
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
‘Extensive’ Proposed Rule Sets Stage for Value-Based Purchasing, PDGM Adjustments
The U.S. Centers for Medicare & Medicaid Services (CMS) released its FY 2020 home health proposed payment rule on Monday, while simultaneously announcing plans for […]
Medicare “negotiation” proposals threaten Americans’ access to medicines
While more than 90% of seniors and people with disabilities report that they are very satisfied with their Medicare Part D prescription drug coverage, they […]
Former CMMI director’s new company will focus on value-based rural healthcare
Main Street Health, launched by former Center for Medicare & Medicaid Innovation Director Brad Smith, aims to provide value-based care solutions in rural America. The […]
New Alzheimer’s Drug Could Cost the Government as Much as It Spends on NASA
The Alzheimer’s treatment will cost $56,000 per patient, and millions may use it. The result: “crazy numbers” for Medicare.
New Alzheimer’s Drug Could Cost the Government as Much as It Spends on NASA
The Alzheimer’s treatment will cost $56,000 per patient, and millions may use it. The result: “crazy numbers” for Medicare.
KHN’s ‘What the Health?’: The ACA Lives
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
HHS Issues New Reporting Requirements, Deadlines for Provider Relief Fund Recipients
Home health providers may have some additional financial aid in the not-too-distant future, as the federal government reportedly inches closer toward disbursing another round of […]
Innovaccer Unveils Health Plan Analytics Tool to Give a Comprehensive View of Over 700 Medicare Advantage Plans
What You Should Know: –Innovaccer Inc., a leading healthcare technology company, recently launched its Health Plan Analytics tool, which provides a comprehensive view of health […]
How Might Lowering the Medicare Age Affect Medicaid Enrollees?
This issue brief highlights key differences between Medicare and Medicaid and raises questions about how a policy to lower the age of Medicare eligibility could […]
FDA’s Approval of Biogen’s New Alzheimer’s Drug Has Huge Cost Implications for Medicare and Beneficiaries
The question of what would happen when a new, expensive prescription drug comes to market for a disease like Alzheimer’s that afflicts millions of people […]
Clover Health Announces In-Home Primary Care Expansion, Becomes New Target for Reddit Traders
Clover Health (Nasdaq: CLOV) announced Wednesday that it plans to scale its in-home primary care program, “Clover Home Care,” through the new direct-contracting model from […]
CMS ups Medicare payment for at-home vaccinations to about $75 per dose
CMS is increasing the payment for administering at-home Covid-19 vaccinations from around $40 to $75 per dose. The move comes amid the Biden administration’s push […]
Medicare Advantage vs. Medicare FFS: A Systematic Review
Medicare Advantage has grown over time. In 2020, nearly four in ten (39%) of all Medicare beneficiaries – 24.1 million people out of 62.0 million […]
Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private […]
One Medical expands into Medicare with $2.1B Iora purchase
Primary care startup One Medical is buying Iora Health for $2.1 billion. The deal will give One Medical a bigger geographic footprint, and crucially, a […]
Study: Poor care access, higher costs more likely with private than public insurance
People with private insurance report poorer access to care, higher costs and lower satisfaction as compared to those with public insurance plans, a new study […]
Expanding Insurance Coverage Is Top Priority for New Medicare-Medicaid Chief
The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $1 trillion in federal spending said in one […]
Addus Focused on Sourcing New Home Health Acquisitions, Improving Applicant-Conversion Rates
The COVID-19 public health emergency has solidified the home as a viable and effective care setting. That, in turn, has led to meaningful opportunities for […]
Readers and Tweeters React to Racism, Inequities in Health Care
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. A […]
Survey: 60% of Americans support Medicare expansion strategies
A majority of the general public is in support of expanding Medicare — either by opening it up to all Americans or lowering the eligibility […]
Caring for an Aging Nation
USE OUR CONTENT This story can republished for free. Please contact KHNweb@kff.org for embed codes. Table of Contents A Variety of Services Booming Number of […]
KHN’s ‘What the Health?’: The Return of the Public Option
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to […]
Expanding Medicare to Adults at Age 60 Years—Medicare-for-More?
In this column for the JAMA Health Forum, Larry Levitt examines the implications of lowering Medicare’s age of eligibility, which is emerging as a potential […]
Broad Coalition of Democrats Presses Biden to Expand Medicare
Over 150 House Democrats are pushing the president to include a plan in his infrastructure package to lower the eligibility age, expand benefits and negotiate […]
Medicare Expansion: Broad Coalition of Democrats Press President Biden on Plan
Over 150 House Democrats are pushing the president to include a plan in his infrastructure package to lower the eligibility age, expand benefits and negotiate […]
Impact of COVID-19 on CMS’ value-based programs
Many Medicare payment initiatives aim to link reimbursement to value. Value includes both cost and quality of care. However, measuring quality of care during a […]
Is Your Living Room the Future of Hospital Care?
Major hospital systems are betting big money that the future of hospital care looks a lot like the inside of patients’ homes. This story also […]
KHN Journalists Comment on Abortion Case, Wasted Covid Doses
KHN chief Washington correspondent Julie Rovner discussed the Supreme Court’s decision to hear a challenge in an abortion case from Mississippi on Newsy on Tuesday. Click […]
Lowering the Age of Medicare Eligibility to 60 Could Reduce the Cost of Health Care and Have a Modest Effect on the Number of People Who Are Uninsured
A new KFF analysis shows that lowering the age of Medicare eligibility to 60 could improve the affordability of coverage for people who are already […]
As Pandemic Eases, Many Seniors Have Lost Strength, May Need Rehabilitative Services
Ronald Lindquist, 87, has been active all his life. So, he wasn’t prepared for what happened when he stopped going out during the coronavirus pandemic […]
Zing Health Acquires Medicare Advantage Plan Provider Lasso Healthcare
What You Should Know: – Zing Health Enterprises, a physician-founded and led provider of Medicare Advantage health plans, has signed definitive documents to acquire Harrisburg, […]
More Than 1 in 4 Medicare Beneficiaries Had a Telehealth Visit Between the Summer and Fall of 2020
As the coronavirus pandemic kept people home last year, just over 1 in 4 Medicare beneficiaries had a telehealth visit with a doctor or other […]
Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future
This brief provides an overview of changes in coverage of telehealth under traditional Medicare before the coronavirus pandemic, and estimates changes in use of telehealth […]
Limitations of CMS’s Hospital Star Ratings System
Is your hospital high quality? Well, this depends on what quality means. Does it have low readmission rates? Low rates of mortality? Do they follow […]
CMS’ rule granting speedy coverage to FDA-designated ‘breakthrough’ devices delayed again
CMS delayed the start date of its rule that would provide expedited Medicare coverage for products the FDA deems “breakthrough devices” from May 15 to […]
Clover halves membership projections for direct contracting
When it planned to go public through a SPAC merger, insurance startup Clover Health told investors that it already had 200,000 direct contracting lives under […]
Medicare-Covered Older Adults Are Satisfied with Their Coverage, Have Similar Access to Care as Privately-Insured Adults Ages 50 to 64, And Fewer Report Cost-Related Problems
This brief analyzes current experiences of Medicare beneficiaries ages 65 and older with respect to satisfaction and access measures and examines whether privately-insured adults ages […]
The ABCs (and Ds) of Medicare
For nearly 60 years, Medicare has helped pay for medical care for Americans over the age of 65, as well as younger Americans with certain […]
You’ve Added Your Kids to Your Health Plan. What About Mom?
SACRAMENTO — When Laura Chavez’s 74-year-old mom needed eye surgery last month, Chavez paid cash for the procedure. This story also ran on Los Angeles […]
32 hospitals in non-Medicaid expansion states sue HHS over payments for low-income patients
The hospitals are pushing HHS to recognize patients eligible for Medicaid under the ACA as “low-income” when calculating Medicare disproportionate share hospital payments in states […]
InnovAge CEO: ‘We Have a Couple of Irons in the Fire’
Even though InnovAge (Nasdaq: INNV) is already one of the largest Program of All-Inclusive Care for Elderly (PACE) providers in the U.S., the company has […]
Covered California Says Health Insurance Just Got Too Cheap to Ignore
If you are uninsured because health coverage seemed too expensive the last time you looked, it’s time to look again. Use Our Content It can […]
Shorter SNF Stays Could Mean More Room for Home-Based Care
Patients recovering at a skilled nursing facility (SNF) can often be discharged home much sooner than they typically are without resulting in a negative health […]
Hoping to Age in Place, Americans Want Long-Term Care Help from Medicare
Given a choice, the vast majority of U.S. adults would still prefer to receive long-term care in their own homes instead of moving into a […]
Health Insurer Financial Performance in 2020
This analysis examines insurers’ financial data across markets through the end of 2020. It finds that average margins remained relatively high compared to recent years, […]
CMS Medicare Provider Enrollment Requirements Could Drive Home Health Agencies Out of Business
Changes to the requirements for Medicare provider enrollment could have major consequences for home health providers down the line. Under provider enrollment requirements, the U.S. […]
CMS proposes putting $2.5B into hospitals’ coffers, eliminating part of price transparency rule
CMS has released its proposed inpatient payment rule for fiscal year 2022, which includes a payment bump that could increase reimbursement for hospitals by $2.5 […]
Lowering the Age of Medicare Eligibility Would Likely Reduce Health Spending for Employers, But Raise Costs for the Federal Government by Covering More People in Medicare
Two new KFF analyses find that lowering the age of Medicare eligibility from 65 to 60 could significantly reduce health spending for employers, who could […]
Health Spending for 60-64 Year Olds Would Be Lower Under Medicare Than Under Large Employer Plans
During the presidential campaign, President Biden proposed to lower the age of Medicare eligibility from 65 to 60. This analysis uses claims data for covered […]
How Lowering the Medicare Eligibility Age Might Affect Employer-Sponsored Insurance Costs
This analysis for the Peterson-KFF Health System Tracker illustrates the potential for employer savings if the age of Medicare eligibility were lowered to 60, as […]
Time to Say Goodbye to Some Insurers’ Waivers for Covid Treatment Fees
Just as other industries are rolling back some consumer-friendly changes made early in the pandemic — think empty middle seats on airplanes — so, too, […]
Implications for the Affordable Care Act under the Biden administration
Unless the Supreme Court strikes down the ACA, it will remain in place for the foreseeable future and will see expansion.
The impact of filling the donut hole
Medicare Part D has a confusing benefit system. Prior to 2011, patients had a deductible, then a general coverage benefit (with 25% coinsurance) then a […]
Humana Health Plan Overcharged Medicare by Nearly $200 Million, Federal Audit Finds
A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to […]
3 Strategies to Up-Level Medicare Advantage Enrollment Before it is Too Late
Trey Keller, VP of Product Management at Edifecs Aaron Fulner, Sr. Director at Edifecs With a new administration looking to reshape healthcare policy and additional […]
Analysis Finds That a Relatively Small Number of Drugs Account for the Majority of Medicare Prescription Drug Spending
A new KFF analysis finds that a relatively small share of drugs, mainly those without generic or biosimilar competitors, accounted for a disproportionate share of […]
Relatively Few Drugs Account for a Large Share of Medicare Prescription Drug Spending
As policymakers focus attention on proposals to lower prescription drug costs by allowing price negotiation or international reference pricing for a limited number of drugs, […]
KHN’s ‘What the Health?’: Pause and Effect on Covid Vaccines
Can’t see the audio player? Click here to listen on SoundCloud. The effort to vaccinate Americans against covid-19 took a hit this week. The Centers for […]
New Research Highlights ‘Surprising’ Findings About COVID-19’s Impact on Mortality in Community, Long-Term Care Settings
Since last spring, there has been a consistent — and justifiable — narrative that long-term care residents are particularly vulnerable to the deadly COVID-19 virus. […]
Navigating the complexities of health coverage and reimbursement beyond the pandemic
Product featured in this article: Coverage Discovery As of the end of March 2021, more than 53 million Americans have been fully vaccinated, allowing for […]
Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity
The first quarter of 2021 has been one of investor optimism as the vaccine rollout continues ahead of expectations and economic activity begins to accelerate in […]
Biden Seeks $400 Billion to Buttress Long-Term Care. A Look at What’s at Stake.
There’s widespread agreement that it’s important to help older adults and people with disabilities remain independent as long as possible. But are we prepared to […]
Time and Goals Should Drive Your Post-COVID-19 Care Management Strategy
Jessica Scruton, BSN, RN, CCM, VP of Clinical Transformation for Lightbeam Health Solutions COVID-19 forced many health systems to reassess and reconfigure their care management […]
How a Virtual Care Mindset Leads to Greater Patient Acceptance and Sustainable Telehealth Growth
Sandeep Pulim, MD, Chief Medical Officer at Bluestream Health There’s no question that the demand for telehealth and virtual care has grown exponentially over the […]
Highlights from MedPAC’s Spring 2021 Report
Here are a few highlight’s from the March 2021 report on Medicare Payment Policy from the Medicare Payment Advisory Commission (MedPAC). Leading causes of death […]
Medicare eats the world
In 2020, Medicare premiums and cost sharing were estimated to consume 24 percent of the average Social Security benefit, up from 14 percent in 2000. […]
Time to Reboot “Medicare-For-All”
By MIKE MAGEE In the fog of the Covid pandemic, many are wondering what ever happened to prior vocal support for universal coverage and Medicare-for-All. […]
KHN’s ‘What the Health?’: Planning for Round Two
Can’t see the audio player? Click here to listen on SoundCloud. Congress is out of session, but that hasn’t stopped Democrats from planning their next round […]
Boost Operational, Clinical and Financial Performance with Good Data
Peter Nelson, VP & General Manager, Global Alliances at GHX There’s an old adage that every challenge is merely an opportunity in disguise. COVID-19 highlighted […]
Report: MA saves beneficiaries $1,600+ compared to traditional Medicare
Medicare Advantage beneficiaries spend $1,640 less per year on healthcare than those enrolled in traditional fee-for-service Medicare plans, a new report shows. But, despite the […]
What Home Health Providers Need to Know About Medicare Loan Recoupment
It has been six months since the U.S. Centers for Medicare & Medicaid Services (CMS) gave home health agencies and other Medicare providers a reprieve […]
Moving the Needle on Prescription Drug Costs: Using the Innovation Center and Other Demonstration Authority
This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to […]
