Navigating Healthcare Transparency: Administration’s Push for Medicare Advantage Clarity
Medicare beneficiaries are often uninformed on prices, supplemental benefits, and the use of prior authorization in their Medicare Advantage (MA) plans. In a landscape where healthcare decisions can feel opaque, transparency could empower patients in navigating the Medicare Advantage program. New initiatives and regulations by HHS and CMS are working to enhance transparency within Medicare […]
Not Just Another Election Year Blog Series: The ACA and the 2024 Election
Not Just Another Election Year Blog Series: The ACA and the 2024 Election This blog post kicks off a series on health care policy and the 2024 election. Unless you are living under a rock, or in a state of denial, you probably realize there will be an election in 2024. When many people think […]
How does MedPAC work: A study in physician payments
A recent post came out saying, “How Out Of Touch is MedPAC? – They Are Recommending ONLY a 1.25% Payment Rate Increase for Physicians for 2024” – and it made us think, maybe some folks don’t know how MedPAC works? We wanted to give a little inside baseball to explain the MedPAC Medicare payment update […]
Heating Up the Debate: The Latest on Medicare Advantage Plans from Washington, D.C.
Greetings from Washington, While temperatures are dropping here in D.C., the Administration and some members of Congress are doing their best to heat it right back up by putting Medicare Advantage (MA) plans on blast. However, the Medicare Payment Advisory Commission (MedPAC) must’ve thought those changes weren’t enough as they thoroughly fanned the flames during […]
MedPAC Payment Basics – Our Christmas in October
It’s Christmas in October! For policy geeks like us, the release of the Medicare Payment Advisory Commission’s (MedPAC) payment basics are like a gift that keeps on giving. Not familiar with these beauties? Well, read on, my friend. MedPAC’s payment basics are a Medicare 101 for every payment system within Medicare. They cover all players in the […]
What Happened, What You Missed: October 2-6, 2023
Makers of 10 Drugs Agree to Participate in Medicare Price Negotiations The manufacturers of all 10 drugs selected for Medicare drug price negotiations have agreed to participate in the program, according to a White House announcement. The announcement comes as several drugmakers have filed lawsuits against the Biden administration to stop the drug price negotiation program, including […]
What Happened, What You Missed: May 1-5, 2023
Study: 340B Suppresses Uptake of Biosimilars Hospitals that participate in the 340B Drug Pricing Program see lower adoption of biosimilar drugs, according to a new study from Health Affairs. Roughly a third of the nation’s hospitals participate in the 340B program, which requires manufacturers to provide discounts on most drugs administered in the outpatient setting […]
The Calculations Change – But the Insolvency Dilemma for Medicare and Social Security Remains the Same
The 2023 Medicare Trustees Report showed a positive trend for the Hospital trust fund (Part A) but the Social Security Trustees noted a worsening trend for in their report. For Social Security, insolvency is coming 1 year earlier than last year (in CY 2032, rather than CY 2033), due to inflation, lowering of the GDP, and labor productivity. For Medicare, […]
What Happened, What You Missed: April 3-7, 2023
Final Rule Prohibits Deceptive Marketing of MA Plans Medicare Advantage (MA) plans and Medicare prescription drug plans will face tougher requirements on marketing plans, according to a rule finalized by the Centers for Medicare and Medicaid Services (CMS) on Wednesday. The final rule is part of an overarching effort by the administration to crack down on deceptive […]
Fixing Medicare’s Insolvency Requires Both the Administration and Congress – So Where Are They?
The 2022 Medicare Trustees Report was full of grim news – namely, that the Hospital Insurance (HI) Trust Fund is projected to hit insolvency by 2028. Given the serious implications insolvency could have on access to care, stakeholders have been begging Congress and the administration to do something. However, Washington has avoided serious attempts to address the HI Trust Fund’s insolvency for years, […]