The Biden Administration has announced its list of the first 10 drugs that will be subject to price negotiations, a step allowed for the first time when Congress passed last year’s Inflation Reduction Act. The Pharmaceutical Manufacturers’ Association (PhRMA), the main drugmaker lobby, blasted the law. No surprise there. But its reasoning is evidence of how perverse the US health [...]
The federal agency that operates Medicare, the Centers for Medicare and Medicaid Services (CMS), is finally recognizing what families have known for, well, thousands of years: Family members are the bedrock of the system of care for frail older adults and younger people with disabilities. And the agency is taking some important steps to help them. Some proposals will provide [...]
In his budget due to be released tomorrow, President Biden will propose major changes in the way Medicare’s Part A hospital insurance program is funded. To ensure the program’s solvency, he’d shift hundreds of billions of dollars in tax revenues and allocate $200 billion in cost savings from other parts of Medicare to the hospital insurance (HI) trust fund. Biden’s [...]
Half of Medicare beneficiaries, about 30 million people, are enrolled in Medicare managed care plans such as Medicare Advantage (MA). And increasingly those plans are offering modest, but important, non-medical services to older adults living at home. These supplemental services are the only long-term care-type benefits most seniors will receive through Medicare. The assistance may include anything from meal and [...]
It Is Medicare open-enrollment season. And retirees are confronting the usual confusion about what to do. Perhaps the biggest question: Should I enroll in a Medicare Advantage managed care plan or in traditional, fee-for-service Medicare? Like almost everything in the world of insurance, the answer is: It depends. In 2022, almost half of all Medicare beneficiaries were enrolled in MA [...]
Medicare Advantage (MA) managed care plans have the potential to vastly improve care for older adults in the US. A fully-integrated health model that combines primary and specialty care, physical therapy, hospital care and even some limited personal supports could improve the quality of life for patients and save the government a substantial amount of money. But increasingly, analysts say [...]
The Medicare trustees’ new estimate that the program’s Part A Hospital Insurance (HI) Trust fund will remain solvent for an extra two years—to 2028—sounds like good news. But dig deeper into the 257-page report and the news is grim for the future of Medicare and its 64 million beneficiaries. Headlines from the trustees’ annual report always focus on the depletion [...]
Medicare Advantage managed care plans, which in 2021 covered 26 million enrollees, will get an average 8.5 percent increase in total Medicare payments next year. At the same time, MA plans are rapidly embracing a wide range of social services and supports for older adults living at home. Sometimes called long-term care lite, these benefits range from meal and food [...]
Congressional Democrats are expected to include a broad expansion of traditional Medicare benefits-- including dental, vision, and hearing—in a $3.5 trillion social spending bill they’ll consider later this year. The move would be the biggest expansion of Medicare since Congress added a drug benefit in 2003 and would go a long way toward improving the health and well-being of millions [...]
In its massive end-of-year spending bill, Congress slipped in some important changes that may improve Medicare coverage for hundreds of thousands of older adults who don’t enroll when they first are eligible. Unfortunately, lawmakers only did half the job. The changes will help, but Congress chose to ignore the real cause of the problem. This is complicated, just like everything [...]