Unbiased Analysis of Today's Healthcare Issues
That may be the case. Modern Healthcare reports: Last month, St. Charles Health System threatened to cut ties with all Medicare Advantage plans next year, a move that would leave an estimated 26,000 local beneficiaries without access to a hospital less than 100 miles away.“The reality of Medicare Advantage in central Oregon is that it…
That is the question Park, Langellier, and Meyers (2022) aim to estimate in their recent Health Services Research publication. The authors use 2015-2017 data from the Centers for Medicare and Medicaid services and control for other differences between integrated and non-integrated Medicare Advantage (MA) plans using state fixed effects and contract random effects. Using this…
That is the connection made between Medicare Advantage (MA) Star Ratings under the Quality Bonus Program (QBP) and Garrison Keillor well-known segment on the Prairie Home Companion in a recent paper by Teno and Ankuda (2022). To better understand this linkage, first recall the famous quote from Mr. Keillor: That’s the news from Lake Wobegon,…
Fierce Healthcare reports that in 2022 Medicare Advantage enrollment is continuing to grow at the expense of traditional fee-for-service Medicare. They write that: Medicare Advantage plans signed up another 2.3 million beneficiaries for the 2022 coverage year, with the program now making up 45% of all Medicare enrollment, a new study found. …total 2022 enrollment…
Medicare Advantage has grown over time. In 2020, nearly four in ten (39%) of all Medicare beneficiaries – 24.1 million people out of 62.0 million Medicare beneficiaries overall – were enrolled in Medicare Advantage (MA) plans. With MA enrollment growing, a key question is who provides higher quality care: Medicare fee-for-service (FFS) or MA? Who…
Some fun facts from Kaiser Family Foundation about Medicare Part D, which covers prescription drugs. Enrollment has doubled since Part D’s inception in 2019. Enrollment in managed care drug plans (i.e., Medicare Advantage Part D Plans [MA-PD]) has continued to grow, but enrollment in stand alone Part D Plans [PDP] has leveled off or decreased.…
Conventional wisdom holds that Medicare Advantage provides better service and lower cost sharing than traditional Medicare fee-for-service, and thus is attractive for many people. However, Medicare Advantage may restrict access to providers and may be less attractive to patients with more severe illnesses. Healthcare economists, however, do not rely on rumors and stories to make…
CMS recently authorized Medicare Advantage (MA) plans the ability to apply step therapy protocols to Part B drugs. Although it is not clear the degree to which the MA plans will implement step therapy, a good guide is to see what is happening in the commercial insurance market. A Health Affairs blog by Chambers, Panzer and Neumann attempts…
While most patients in Medicare use the traditional fee-for-service route, a growing percentage of Medicare beneficiaries are relying on managed care plans through Medicare Advantage. Medicare Advantage provides beneficiaries with additional choice and also serves as a competitive alternative to traditional Medicare. In theory, Medicare should just allocate a beneficiary’s funding to a managed care…
CMS has focused in recent years on payment reform–especially alternative payment models–in Medicare’s fee-for-service (FFS) reimbursement system, but much less has been paid to beneficiaries enrolled in Medicare’s managed care program (i.e., Medicare Advantage). Currently, however, more than 1 in 3 beneficiaries are enrolled in an Medicare Advantage plan, and by 2028 that number could…