Will the Trump Administration push more beneficiaries into Medicare Advantage managed care plans? Will the Administration limit payments to the insurance companies that run those plans? Will it do both? Whatever Trump does, the consequences will be significant for older adults and younger people with disabilities who rely on Medicare for their health care. Done well, an overhaul of MA [...]
President Trump’s advisor Elon Musk went on TV the other day to say he’d cut up to $700 billion in fraud and waste from Social Security, Medicare, and Medicaid. He can’t. The inevitable result: He’ll have to either slash benefits for program recipients or fall far short of his goals for cutting government spending. Or, perhaps, both. The Trump White [...]
Medicare Advantage prior authorizations have few friends. Doctors hate them. Patients hate them. Politicians say they hate them and introduce bills to curb them. But how onerous are they really? Less than many people think. But they still create opportunities for insurance companies to maximize profits at the expense of needed care. And they can be improved. Prior authorizations are [...]
The incoming Trump Administration has been sending mixed signals about the fate of Medicare. But if Trump advisers and GOP lawmakers are serious about slashing government spending it is hard to see how they will ignore the program, which last year cost $850 billion and accounted for about one out of every six dollars the federal government spent. Trump’s problem: [...]
The US health system focuses an enormous amount of money and attention on post-acute care—the medical treatment patients receive after they have been discharged from a hospital. But it would more cost effective, and far better for patients, to refocus on what you might call pre-acute care: What the US can do to prevent those hospitalizations in the first place. [...]
In response to the recent burst of inflation, the government increased Social Security benefits significantly in the past two years. But compared to average pre-retirement income, net benefits have been falling for decades. And the trend will continue. One big reason: Rapidly rising Medicare premiums that usually are deducted directly from Social Security checks. Think about Social Security benefits in [...]
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 [...]
As the Covid-19 public health emergency ends, many older adults who need a post-hospital stay in a skilled nursing facility (SNF) will be in for an unpleasant surprise: Traditional Medicare may not pay. The change, one among dozens that affect older adults, restores rules from before the pandemic. But they are complicated and will shock many patients and their families, [...]
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 [...]