Unbiased Analysis of Today's Healthcare Issues
For researchers interested in studying the Medicare prescription drug benefit, CMS has claims data for Medicare Part D. Academy Health also has a useful powerpoint presentation giving some more information regarding Medicare Part D and what information is available as part of the CMS Medicare Part D claims data.
The controversy as to how much Medicare should pay doctors is continuing to brew (see N.Y. Times article). Congress passed a law overriding a pay cut to Medicare doctors. Although the president vetoed the bill, Congress garnered enough support to override the veto. Dr. Rich of The Covert Rationing Blog claims that the Medicare reimbursement…
As I noted in an earlier post, choosing a Medicare part D plan is difficult. However, there are resources to help people choose a Medicare Part D plan based on which prescriptions they are taking and where they live. Medicare has its own Personalized Plan Search. The private sector also has come up with user-friendly…
According to an article on TheHill.com, Medicare denies more claims than commercial insurers. “Medicare was the most likely to deny any part of a claim, with a 6.9 percent rate. Aetna was a close second at 6.8 percent while the others ranged from 2.7 percent to 4.6 percent. Coventry Health had the fastest median turnaround…
What is Medicare Part D? Medicare Part D began in 2006 and provides insurance coverage for pharmaceuticals for the elderly. The program is set up so that the government does not purchase the drugs directly, but subsidizes private prescription drug plans, which then negotiate prices with the pharmaceutical companies. There are two types of Part…
David Whelan chronicles the rise (and possibly future fall) of Medicare Advantage programs in his article “Unfilled Prescription” in Forbes. Earlier laws privatizing Medicare, starting with a pilot program in 1985, were written to give insurance companies only 95% of the money otherwise spent per Medicare member. The insurers were supposed to figure out how…
Medicare is inefficient and expensive. Medicare has been expanded through Medicare Part D, which covers prescription drugs. Can expanding an inefficient, expensive system be a good thing? Gary Becker argues yes. Since drugs have high fixed research costs but low marginal costs, having the government pay for drugs can increase innovation. In fact, a working…
The [Medicare Hospital Insurance Trust] fund also continues to fail our long-range test of close actuarial balance by a wide margin. The projected date of HI Trust Fund exhaustion is 2019, the same as in last year’s report, when dedicated revenues would be sufficient to pay only 78 percent of HI costs. Projected HI dedicated…
The Wall Street Journal has an interesting article (“Markets and Medicare“) by John Goodman, President of the National Center for Policy Analysis. The article has some innovative suggestions regarding how to improve the health care system. Medicare should allow alternative payment mechanisms, such as compensating doctors for e-mail and telephone communication with the patient (I…
Which Medicare plan should you choose? Health journalist Charles Ornstein of the L.A. Times was making just this choice for his mother in “Puzzling out plan option for Medicare.” Even for a veteran health journalist, the choice is not as easy as it seems. Below, I will give some background information which will help people…