To the shock of the big insurance companies that run most Medicare Advantage managed care plans, the government has proposed boosting payments to plans by just 0.09% in 2027. That would be a fraction of the annual increase plans received in the past and far below what they, and their investors, expected. Share prices plummeted and plan executives darkly warned [...]
Twenty-five years ago, there were about 35 million Americans age 65 or older and about 10,000 board certified specialists in geriatric medicine to care for them. Today, there about 60 million older adults in the US. And the number of geriatricians has fallen to about 7,300. Perhaps more troubling, it appears that physicians are going into other specialties, such as [...]
Medicare’s new hospital payment experiment, which it calls TEAM (Transforming Episode Accountability Mode), may have profound effects on patients, their families, and providers such as nursing homes and home health agencies. While the acronym signals the virtues of collaboration and shared goals, its outcomes are far less certain. At its best, TEAM will encourage hospitals to improve the quality of the [...]
Our deeply fragmented health system is especially dangerous for older adults, younger people with disabilities, and their families. In an effort to improve their care, the federal Centers for Medicare and Medicaid Services is rolling out several experimental payment models aimed at better coordinating care and, perhaps, saving Medicare money. The demonstrations, described by a growing cacophony of acronyms, work [...]
While Congress and President Trump fruitlessly debate how much the government should subsidize certain health insurance premiums, they are missing a far more important question: How could the US rationalize our eight (at least) completely separate health insurance systems? This maze-like complexity comes at a price. Dividing Americans into multiple risk pools increases health care costs. It means patients lose [...]
When politicians use their favorite buzzword of the day “affordability,” they most likely are talking about housing, insurance, or beef. But they also should be thinking about the costs of personal care for older adults and younger people with disabilities, which is becoming less affordable than ever. And one big reason is the Trump Administration’s war on immigrants. As its [...]
After a government shutdown and months of drama, it appears that President Trump may be about to drop his aggressive opposition to extending soon-to-expire enhanced Affordable Care Act subsidies. And by doing so, he may have made it much more likely that 22 million people currently receiving premium tax credits will continue to receive their full subsidies. Preserving the subsidies, [...]
Navigating the highly complex and deeply fragmented systems of medical and long-term care is one of the biggest challenges family caregivers face. How do I find a reliable home care aide? Where is a good adult day center? How can I coordinate dad’s medical treatment with his personal care? Now, new care navigation services are filling the gaps, many offered [...]
Progressives are fuming over the decision by eight Senate Democrats to support a bill to reopen the federal government without an agreement on extending enhanced Affordable Care Act health insurance subsidies beyond December. Allies of President Trump are gloating at what appears to be Democratic capitulation to the White House’s hardball tactics. But while Democrats lost this skirmish in the [...]
Even as most policymakers continue to ignore the looming insolvency of Social Security—and the 23% reduction in benefits it will produce in seven years—policy experts across the political spectrum increasingly are leaning into the challenge, often in creative new ways. While they have developed broadly different solutions, they share similar goals: To restore long-term solvency of the program while improving [...]