English
Arabic
Chinese (Simplified)
Dutch
Esperanto
French
German
Greek
Italian
Japanese
Korean
Portuguese
Russian
Spanish
UrduMedicare could waste up to $605 million per year on the controversial Alzheimer’s drug aducanumab if it is eventually approved for widespread use because it is supplied in vials containing fixed doses that may not be appropriate for all patients–resulting in the trashing of large volumes of unused drug
Tag: Medicare
Medicare could save up to $3.6 billion by purchasing generic drugs at Mark Cuban prices
A brief research report found that Medicare could have saved up to $3.6 billion by purchasing generic drugs at the same prices as the Mark Cuban Cost Plus Drug Company (MCCPDC) in 2020. These findings suggest that Medicare is overpaying for some generic drugs. The report is published in Annals of Internal Medicine.
Dementia diagnosis often comes as part of costly crisis
Medicare costs around the time of a dementia diagnosis are much lower for older adults screened proactively rather than those diagnosed while experiencing a health issue.
Private insurers paid hospitals 224% of what Medicare would in 2020
Prices paid to hospitals during 2020 by employers and private insurers for both inpatient and outpatient services averaged 224% of what Medicare would have paid, with wide variation in prices among states, according to a new RAND Corporation report.
What drives racial and ethnic gaps in Medicare’s quality program?
The improvements in care for older adults from the Accountable Care Organization movement haven’t reached all older Americans equally. ACOs that include a higher percentage of patients who are Black, Hispanic, Native American or Asian have lagged behind those with higher percentage of white patients in providing preventive care and keeping patients out of the hospital. Now, a new study shows that some of this inequity stems from how an ACO’s patients get their primary care.
Senate Introduces Bill to Provide Full Chiropractic Coverage in Medicare
The U.S. Senate has introduced a bill, S. 4042, to modernize Medicare coverage and better meet the needs of today’s seniors by increasing access to services provided by doctors of chiropractic.
CMS 2022 final rules: ASTRO deeply concerned and disappointed, emphasizes need for legislative solution
The American Society for Radiation Oncology (ASTRO) issued the following statement today in response to the 2022 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) final rules announced by the Centers for Medicare and Medicaid Services (CMS).
It’s Medicare Open Enrollment Time: Beware of Plan Restrictions That Limit Access to Sight-Saving Care
The American Academy of Ophthalmology (AAO) and the American Society of Cataract and Refractive Surgery (ASCRS) are urging consumers to be aware of insurance policies that can limit their access to sight-saving procedures and treatments.
New study finds domestic reference pricing could lower Medicare spending on new drugs by 30%
Basing new drug launch prices on historical domestic data could limit manufacturers’ power to set extremely high launch prices and could reduce Medicare spending on new drugs by up to 30%, according to a new white paper released today by West Health and its Council for Informed Drug Spending Analysis (CIDSA).
Mayo Clinic Community Accountable Care Organization delivers high-quality care, Medicare savings
The Mayo Clinic Community Accountable Care Organization (ACO) LLC earned a quality score of 97.81% while generating $32.3 million in cost savings for the Medicare program in 2020.
Turning 65 means a lot for Americans’ wallets, health spending study finds
Lowering the age when older adults can enroll in Medicare might save them a lot of money, even if the age drops only a year or two from the current age of 65, a new study suggests. Such a change could especially affect the small percentage of people in their early 60s who spend a major chunk of their disposable income on health costs.
UC San Diego Health Earns High Quality Marks, Saves Medicare Money
UC San Diego Health improved care for more than 32,000 Medicare beneficiaries in San Diego, Riverside, and Imperial Counties, and saved Medicare close to $7 million by utilizing population health technologies to exceed quality and cost goals in 2020.
The Impact of Value-Based Mental Health Care on Racial and Ethnic Disparities
A new study, published in print this month in the journal Health Services Research found that the Medicare Shared Savings Program (MSSP) reduced disparities in outpatient mental health services among Native American beneficiaries.
ASTRO responds to troubling Medicare cuts and Radiation Oncology Model update
In response to consecutive weeks of significant proposed Medicare payment cuts to radiation oncology cancer care, Thomas J. Eichler, MD, Chair of American Society for Radiation Oncology (ASTRO), issued the following statement.
Aging U.S. Immigrant Population Poses Challenges to State Health Care Systems
A team led by Dr. Arturo Vargas Bustamante, UCLA Fielding School of Public Health professor of health policy and management and director of faculty research at the UCLA Latino Policy and Politics Initiative (LPPI), has found the United States faces a potential crisis in terms of health care for documented, and undocumented immigrants.
Dusetzina Appointed to Federal Medicare Payment Advisory Commission
Stacie B. Dusetzina, PhD, associate professor of Health Policy and Ingram Associate Professor of Cancer Research at Vanderbilt University School of Medicine has been appointed to a three-year term on the Medicare Payment Advisory Commission (MedPAC).
Providing more low-value care doesn’t lead to higher patient experience ratings
Many healthcare providers and policy makers fear that increased pressure to please patients — and ensure high satisfaction ratings as a result — could lead to overuse of low-value care that doesn’t provide any clinical benefit while unnecessarily ratcheting up medical bills. But new research from the University of Chicago and Harvard Medical School may alleviate some of those concerns.
Radiologist Participation in Value-based Care Tripled Over 5 Years
This new Harvey L. Neiman Health Policy Institute study found that radiologist participation in Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) increased over three-fold from 10.4% to 34.9% between 2013 and 2018. The study is published online in the Journal of American College of Radiology.
Academy of Nutrition and Dietetics Urges Swift Passage of Bill That Would Increase Access to Nutrition Care
The Academy of Nutrition and Dietetics supports expanding medical nutrition therapy to provide Medicare beneficiaries with the care they need and deserve to live healthy, independent lives.
Nearly $500 million a year in Medicare costs goes to 7 services with no net health benefits
A UCLA-led study shows that physicians frequently order preventive medical services for adult Medicare beneficiaries that are considered unnecessary and of “low value” by the U.S. Preventive Services Task Force — at a cost of $478 million per year.
House Reintroduces Bill to Modernize Medicare’s Chiropractic Coverage
The Chiropractic Coverage Modernization Act (H.R. 2654), introduced April 19 in the U.S. House of Representatives, would increase Medicare coverage of services provided by doctors of chiropractic within the full extent of their state licensure, enabling chiropractic patients to conveniently and safely access needed care.
AANA Applauds Presidential and Congressional Action to Delay Medicare Sequester
Healthcare providers, including Certified Registered Nurse Anesthetists (CRNAs), will continue to receive resources to care for some of the most vulnerable patients with President Biden signing of H.R. 1186 to postpone a 2% cut to Medicare reimbursements for healthcare providers.
Health Policy Researchers Propose Filling Health Care Coverage Gap to Help ‘Near Poor’
“Near-poor” Americans – people just above the federal poverty level but still well below the average U.S. income – who rely on Medicare for health insurance face high medical bills and may forgo essential health care, according to new research.
Leaders of the American Association of Nurse Anesthetists Ask Congress to Delay Medicare Sequester
Leaders of the American Association of Nurse Anesthetists (AANA) have asked Congress to prevent a 2% cut to Medicare reimbursements for healthcare providers effective March 31, 2021.
Geriatric Emergency Departments Associated with Lower Medicare Expenditures
As the U.S. population ages, more hospitals are implementing geriatric emergency department (GED) programs with specialized staff focused on transitional care for older adults. A new study finds that providing specialized geriatric emergency care results in lower Medicare expenditures up to $3,200 per beneficiary.
Bipartisan House and Senate Majorities and Health Care Providers Urge Action to Stop Medicare Provider Cuts
Medicare cuts to a million health care providers, many reeling from the economic impact of COVID-19, may cause practice closings, service reductions, job losses and decreased access to care. With the cuts to start Jan. 1, nearly 400 medical organizations and 329 members of Congress are calling to #StopTheCuts
American Society of Anesthesiologists Urges Medicare to Keep Physician-led Anesthesia Care to Protect Older Patients and Patients with Disabilities
The U.S. Department of Health and Human Services (HHS) recently issued a request for information regarding waivers declared during the COVID-19 pandemic, including one that removed physician anesthesiologists from anesthesia care and replaced them with nurses. The American Society of Anesthesiologists (ASA) urges Americans to protect older patients and those with disabilities by posting a comment to the Federal Register asking the Centers for Medicare and Medicaid Services (CMS) to rescind the temporary policy that lowers the standard of care and risks patients’ lives.
Congress Must Act To Fortify Health Care System And Protect Access To Care
The final 2021 Medicare Physician Fee Schedule fails to avert the potential impact on seniors of payment cuts to more than a million health care providers already reeling from COVID-19’s financial impact. If Congress does not act now to address these changes, the results may be devastating for patients, communities and providers.
American College of Surgeons calls on Congress to prevent CMS Medicare Physician Fee Schedule from taking effect
The Medicare Physician Fee Schedule released today by the Centers for Medicare & Medicaid Services (CMS) will harm patients and further destabilize a health care system already under severe strain from the COVID-19 pandemic.
61 Healthcare Groups Urge Congress to Support Implementation of the Medicare Physician Fee Schedule
Today, more than 60 healthcare stakeholders, representing Medicare providers, signed a letter urging congressional leaders to support bipartisan legislation that would implement the Centers for Medicare and Medicaid Service’s (CMS) Calendar Year 2021 Medicare Physician Fee Schedule (MPFS) final rule as written.
Biden focuses on health care, but pharma firms have upper hand
President-elect Joe Biden began transition planning with the announcement of a COVID-19 task force, continuing a focus on health care that was a hallmark of the Obama-Biden era, culminating in the passing of the Affordable Care Act. Colleen Carey,…
What’s at stake in the Supreme Court’s ACA case? A quick explainer
Though the election and pandemic have eclipsed it in the news, there’s another event unfolding that could affect nearly all Americans: a Supreme Court case that will decide the future of the Affordable Care Act. A health policy researcher explains what would happen if it’s overturned.
New legislation introduced to protect patient access to surgical care
Representatives Ami Bera, MD (CA-7) and Larry Bucshon, MD (IN-8), along with six lead co-sponsors, introduced legislation today that will protect patients’ access to surgical care by stopping cuts to Medicare payments for surgical specialties.
Modest increases in physician productivity can offset the cost of medical scribes
New research led by Neda Laiteerapong MD, Associate Professor of Medicine at the University Chicago Medicine, indicates the real value of a scribe to a medical practice.
Falling Medicare Reimbursement Rates for Orthopaedic Trauma
The amount Medicare reimburses for orthopaedic trauma surgery has fallen by nearly one-third over the past two decades, reports a study in the Journal of Orthopaedic Trauma. The journal is published in the Lippincott portfolio by Wolters Kluwer.
PTAC Unanimously Recommends First Specialty-focused APM for a Chronic Condition to HHS Secretary for Consideration
The ACAAI PCACP model is a value-based care model that gives physicians specializing in asthma care the resources and flexibility they need to better diagnose and manage patients with asthma.
Generic Cholesterol Drugs Save Medicare Billions of Dollars, Study Finds
DALLAS – Sept. 9, 2020 – The switch from brand name to generic cholesterol medications that occurred between 2014 and 2018 has saved Medicare billions of dollars, even as the number of people on cholesterol-lowering drugs has increased, UT Southwestern scientists have calculated. Their data, published in the journal JAMA Cardiology, suggest that policymakers and clinicians could help cut Medicare costs even further by switching more patients to generic drugs.
Proposed Medicare Cuts Threaten Anesthesiology Practices Already Struggling Amid Pandemic
Medicare has proposed drastic cuts to its payment rates for important health care services, threatening the practices of physician anesthesiologists who have been on the front lines of the battle against the COVID-19 pandemic. The American Society of Anesthesiologists (ASA) opposes these detrimental payment reductions, and urges Congress to take action to override the budget neutrality requirements that are the cause for these cuts and thereby ensure physician anesthesiologists can continue to care for their patients while being more fairly compensated for their work.
ACADEMY OF NUTRITION AND DIETETICS SUPPORTS SENATE INTRODUCTION OF MEDICAL NUTRITION THERAPY ACT
The Academy of Nutrition and Dietetics thanks U.S. Sens. Susan Collins (Maine) and Gary Peters (Mich.) for their commitment to America’s health and their introduction of the Medical Nutrition Therapy Act. This bicameral, bipartisan legislation would provide coverage for Medicare beneficiaries to obtain treatment from registered dietitian nutritionists and other qualified nutrition experts for many common and costly chronic diseases.
Medicare’s Race, Ethnic Data Often Undercounts Minority Populations, Study Finds
Information critical to a nationwide priority of reducing health care disparities among minorities is incomplete and inaccurate, according to a new Rutgers study
Middle-Aged Adults Worried About Health Insurance Costs Now, Uncertain for Future
Health insurance costs weigh heavily on the minds of many middle-aged adults, and many are worried for what they’ll face in retirement or if federal health policies change, according to a new study. More than a quarter of people in their 50s and early 60s lack confidence that they’ll be able to afford health insurance in the next year, and the number goes up to nearly half when they look ahead to retirement.
Study Finds Association Between Patient Therapy Time, Length of Stay After Hip Fracture Surgery
Researchers in the George Washington University Advanced Metrics Lab found that a hip fracture patient’s length of stay in a rehabilitation facility has a greater impact on functional independence than therapy time per day
Ratings system may penalize hospitals serving vulnerable communities
Analysis of the Centers for Medicare and Medicaid Services (CMS) Hospital Compare rating system shows that hospitals serving vulnerable communities may be judged on social factors outside of their control.
Lack of Specialists Doom Rural Sick Patients
Residents of rural areas are more likely to be hospitalized and to die than those who live in cities primarily because they lack access to specialists, according to research in Health Affairs.
Peritoneal Dialysis Use Has Increased in the United States after Medicare Payment Reform
• After a Medicare payment policy related to dialysis was implemented in 2011, use of home-based peritoneal dialysis increased significantly.
• Increases were seen for both “early” and “late” peritoneal dialysis: more patients initiated dialysis with peritoneal dialysis and more patients switched from hemodialysis to peritoneal dialysis.
Too Good to Be True?
New analysis casts doubt on effectiveness of Medicare payment incentive program as a way to curb hospital readmissions Study suggests drop in readmission rates observed after program launch likely stemmed from a broader decline in admissions rather than as a result of the program
The findings highlight the need for implementing policies in ways that allow their impact to be distinguished from other changes in health care
American Society of Anesthesiologists Offers Trump Administration Medical Expertise to Protect and Improve Medicare
ASA today offered it medical expertise to the Trump Administration as it works to improve Medicare beneficiaries’ access to physician care, implement transparency and market-based reforms, while reducing cost and regulatory burdens as provided in President Trump’s Executive Order.
Medicaid Reimbursement for Spinal Surgery Varies Between States
Most states reimburse less for spinal surgery in Medicaid patients, compared to Medicare reimbursement for the same procedures, reports a study in Spine. The journal is published in the Lippincott portfolio by Wolters Kluwer.