Archive


Category: Medicare

  • Are Medicare Advantage Insurers Covering the Cost of At-Home COVID-19 Tests?

    The Biden Administration’s requirement for private insurers to cover the cost of at-home rapid COVID-19 tests for their enrollees does not apply to Medicare. Medicare Advantage plans (offered by private insurers) have the option to cover at-home tests but are not required to do so. This policy watch examines whether some of the largest private […]

  • Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage

    A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. The Jan. 25 ruling, which came in response to a 2011 class-action lawsuit eventually […]

  • KHN’s ‘What the Health?’: Record ACA Enrollment Puts Pressure on Congress

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration announced that 14.5 million Americans have signed up for health insurance under the Affordable Care Act for 2022. That’s a record, and several states […]

  • Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act

    The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope […]

  • Readers and Tweeters: Give Nurse Practitioners Their Due

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. The latest installment in: Hospital Billing is Totally Ridiculous. See also: High Deductibles are Badhttps://t.co/JAk1CfrEuN — Rachel Patterson (@racheljpat) January 24, 2022 — Rachel Patterson, Washington, D.C. In Respect to Nurse […]

  • Why Medicare does not cover rapid at-home Covid tests

    It turns out that the laws governing traditional Medicare don’t provide for coverage of self-administered diagnostic tests. Medicare patients are left to seek free tests other ways, including through the administration’s new website, covidtests.gov, and at community centers.

  • RecoveryOne, Cigna Offers Virtual Physical Therapy for Medicare Advantage Customers

    What You Should Know: – RecoveryOne, a digital health innovator dedicated to improving health outcomes for recovery from musculoskeletal (MSK) injuries of all types and reducing costs, announced an expansion of its partnership with Cigna to offer its virtual physical therapy and broad MSK solution for Medicare Advantage (MA) customers as an in-network benefit.  – This new benefit builds on the […]

  • Why Medicare Doesn’t Pay for Rapid At-Home Covid Tests

    What group is especially vulnerable to the ravages of covid-19 even if fully vaccinated and boosted? Seniors. And who will have an especially tough time getting free at-home covid tests under the Biden administration’s plan? Yes, seniors. As of Jan. 15, private insurers will cover the cost of eight at-home rapid covid tests each month […]

  • CMS Solidifies Vaccination Deadlines, Releases Guidance for Home Health Agencies

    The U.S. Supreme Court on Thursday threw its support behind the nationwide COVID-19 vaccine mandate for health care workers, while simultaneously axing a vaccine-or-test rule for large employers. Last week’s developments shouldn’t shock the in-home care operators that have been following the U.S. Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health […]

  • Medicare Advantage Is a Superior Program (Part two)

    By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for All post-COVID. He wrote a piece in Health Affairs last week arguing with the stance of Medicare Advantage of Don Berwick and Rick Gilfillan (Here’s their piece pt1, pt2). Here’s […]

  • Medicare’s Coverage Decision for the New Alzheimer’s Drug and Why It Matters

    This policy watch discusses the implications of Medicare’s preliminary National Coverage Determination for the new Alzheimer’s drug, Aduhelm, on the 2022 Medicare Part B premium and the possibility of an adjustment based on the coverage decision. The piece also discusses the implications for Medicare spending and the connection to ongoing policy discussions around prescription drug […]

  • [Updated] Supreme Court Blocks OSHA Mandate, Allows CMS Rule to Take Effect

    The long-awaited decisions regarding the Biden administration’s vaccine mandates have finally arrived from the U.S. Supreme Court. In the end, the Occupational Safety and Health Administration (OSHA) “soft” mandate was shot down by SCOTUS by a 6-3 count. The mandate would have applied to all private businesses with 100 employees or more, requiring workers to […]

  • KHN’s ‘What the Health?’: Dealing With Drug Prices

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Medicare officials have preliminarily decided to restrict reimbursement for Aduhelm, the controversial Alzheimer’s drug, to only patients participating in approved clinical trials. The FDA approved the drug […]

  • Medicare limits Aduhelm coverage to clinical trial participants

    Biogen’s difficult launch of controversial Alzheimer’s therapy Aduhelm has been made even harder by a proposal by Medicare to cover the drug only for certain patients enrolled in clinical trials. Biogen and partner Eisai had been hoping for good news from the review of Aduhelm (aducanumab) by the Centre for Medicare and Medicaid Services (CMS), […]

  • Medicare Advantage Is a Superior Program (Part one)

    By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for All post-COVID. He wrote a piece in Health Affairs last week arguing with the stance of Medicare Advantage of Don Berwick and Rick Gilfillan (Here’s their piece pt1, pt2). Here’s […]

  • CMS Releases Vaccine Mandate Guidance for Home Health Providers

    The U.S. Centers for Medicare & Medicaid Services (CMS) released guidance on evaluating providers’ compliance with the federal COVID-19 vaccination mandate for health care workers. Although CMS originally published the interim final rule in November, it posted the guidance for state survey agency directors on Tuesday. Broadly, the guidance applies to providers working under the […]

  • KHN’s ‘What the Health?’: Manchin Blows Up Biden’s ‘Build Back Better’

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Sen. Joe Manchin (D-W.Va.) dashed the hopes of President Joe Biden and congressional Democrats for passage of the giant “Build Back Better” bill before the end of […]

  • Zing Health Secures $25M to Accelerate SDOH-Driven Medicare Advantage Plans

    What You Should Know: – Medicare Advantage provider Zing Health raises $25M from Town Hall Ventures and Leavitt Equity Partners, two leading investors focused on growing innovative healthcare businesses. Zing Health Holdings, a Chicago-based physician-led Medicare Advantage insurance company focused on serving vulnerable populations underserved by traditional insurance models, today announced that Town Hall Ventures and Leavitt […]

  • Biogen takes axe to Aduhelm price in a bid to drive take-up

    Biogen has cut the list price of its Alzheimer’s disease therapy in half from $56,000 to $28,200 a year, before the outcome of an ongoing reimbursement review of the drug by the US government. The price reduction for Aduhelm (aducanumab) comes into play from 1 January and comes on the back of the “feedback of […]

  • Post-approval research save lives. Why is Congress trying disincentivize it?

    While some in Congress continue to claim the latest drug pricing plan in Washington is “negotiation,” that is far from the truth. The reality is that the current plan gives the government a new authority to set prices for medicines in Medicare after a product has been on the market for 7 (small molecule drugs) […]

  • Home Health Providers Failing to Deliver Required Services, New Survey Suggests

    Medicare-certified home health providers are falling short when it comes to the amount of care services they’re offering, a new survey released Thursday from the Center For Medicare Advocacy (CMA) suggests. “Our surveys confirmed what we, unfortunately, hear all the time at [CMA], either directly from the beneficiaries, family members or friends who’ve tried to […]

  • Medicare Transformation Company Ilumed Raises $16.5M to Expand DCE Services

    What You Should Know: – Ilumed, a Medicare transformation company focused on assisting patients to achieve their healthiest lives by driving lower cost, better quality and more equitable healthcare outcomes raises $16.5M in Series A funding led by Ascend Partners. – Ilumed is one of fifty-three Direct Contracting Entities approved by the Centers for Medicare & […]

  • MedPAC Commissioners Question Home Health Access Data, Industry Turnover Rates

    The measurements used to track the home health industry could use some updating to better align perception with reality, according to the Medicare Payment Advisory Commission (MedPAC). And interestingly enough, access may be one of the rare occasions where on-the-ground evidence tells a truer story than available data. “The access to home health appears to […]

  • KHN’s ‘What the Health?’: Much Ado About (Vaccine) Mandates

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Even with the new omicron variant of the covid virus spreading in the U.S., Republicans on Capitol Hill are pushing to stop President Joe Biden from requiring […]

  • House Passes Bill to Delay Medicare Cuts, PAYGO Reductions

    Home health stakeholders that have been on pins and needles about the return of possible Medicare cuts saw the first step toward securing further delay on Tuesday. By a vote of 222-212, the U.S. House of Representatives passed a bill that delays 6% in Medicare cuts set to go into effect Jan. 1. Specifically, the […]

  • Making medicines more affordable: Making insurance work like insurance

    Common-sense reforms can help ensure everyone benefits from America’s engine of innovation and receives the care they need and deserve. In this series, we’re taking a closer look at PhRMA’s advocacy efforts to make medicines more affordable, part of our patient-centered agenda, which aims to lower barriers between our industry’s medical innovations and patients who need […]

  • From ‘Physician Assistant’ to Medicare, Readers and Tweeters Mince No Words

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. On ‘Physician Assistant’: Watch Your Language I think this story left out a few critical pieces of information (“A Title Fight Pits Physician Assistants Against Doctors,” Dec. 3). The term “physician […]

  • Post-Pandemic, What’s a Phone Call From Your Physician Worth?

    Maybe this has happened to you recently: Your doctor telephoned to check in with you, chatting for 11 to 20 minutes, perhaps answering a question you contacted her office with, or asking how you’re responding to a medication change. For that, your doctor got paid about $27 if you are on Medicare — maybe a […]

  • 3 things to know about the importance of post-approval research and development

    Despite tremendous progress and knowledge gained from post-approval R&D, some in Congress still fail to recognize innovation doesn’t stop at U.S. Food and Drug Administration (FDA) approval. After approval, scientists and physicians continue to generate information on a new medicine or vaccine, as we’re seeing with COVID-19 vaccines today. This is done both for approved […]

  • Senior Care Advocates, Hospital Groups Voice Concerns Over Potential 6% Medicare Cut

    Both chambers of Congress passed legislation this week to keep the government funded through Feb. 18. Home health agencies and other Medicare stakeholders are worried, however, about a potential 6% cut that could be coming down the pike. The cuts come in the form of Medicare sequestration and PAYGO. Signed into law in August 2011, […]

  • Dec. 8 Event: Unpacking the Prescription Drug Provisions of the Build Back Better Act

    Wednesday, December 8, 2021 at 9:00 a.m. PT/12:00 p.m. ET As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs. The House-passed bill would allow the federal government to negotiate prices for some high-cost drugs in Medicare, and set…More

  • Dec. 8 Event: Unpacking the Prescription Drug Provisions of the Build Back Better Act

    Wednesday, December 8, 2021 at 9:00 a.m. PT/12:00 p.m. ET As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs. The House-passed bill would allow the federal government to negotiate prices for some high-cost drugs in Medicare, and set…More

  • CMS Vaccine Mandate Blocked in 10 States

    First it was the COVID-19 vaccination mandate from the U.S. Occupational Safety and Health Administration (OSHA). Now, it’s the one from the Centers for Medicare & Medicaid Services (CMS). Since OSHA and CMS released their interim emergency regulations requiring COVID-19 vaccinations for certain individuals, each has been challenged in court. On Monday, a federal judge […]

  • Guest post: Congress shouldn’t put future innovation at risk

    Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The PhRMA blog welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and point of view.

  • Quality of Care at Teaching Hospitals

    Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard reimbursements in an attempt to compensate hospitals for these additional costs. Medicare also pay hospitals directly for some cost of training residents through the graduate medical education (GME). A key […]

  • Impact of biosimilar entry on drug costs

    While generic drugs frequently replace their branded counterparts after the latter lose their market exclusivity, the uptake of biosimilar products is often slower. Further, biosimilars are relatively more expensive compared to generic small molecule drugs. A key question then is how much could payers save by switching to biosimilars after loss of exclusivity. The is […]

  • What’s missing in the current drug pricing plan

    Last week, a congressional forum looked at the role pharmacy benefit managers (PBMs) play in determining what patients pay out of pocket for prescription medicines. The forum provided an important reminder of how these middlemen operate in an opaque system that often leaves patients paying far more than they should for medicines. And it’s also […]

  • Explaining the Prescription Drug Provisions in the Build Back Better Act

    The Build Back Better Act includes several provisions that would lower prescription drug costs for people with Medicare and private insurance and reduce drug spending by the federal government and private payers. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.

  • ICYMI: PhRMA CEO speaks at STAT Summit about government price setting

    As part of the annual STAT Summit, PhRMA President and CEO Stephen J. Ubl recently spoke with STAT’s Matthew Herper to discuss the many unintended consequences expected from the latest drug pricing plan on Capitol Hill, as well as the biopharmaceutical industry’s plans to help build a better health care system that improves patient access […]

  • KHN’s ‘What the Health?’: Boosting Confusion

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. With covid caseloads rising across much of the country, several governors and mayors are unilaterally expanding access to booster shots, getting out ahead of federal health officials. […]

  • EasyHealth Secures $135M to Redesign Medicare Experience

    What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. EasyHealth, an LA-based company connecting coverage and care with an end-to-end Medicare experience, today announced it has raised $135M in equity and […]

  • Three things to know about so-called Medicare “negotiation” polling

    As policymakers continue to push partisan drug pricing proposals, several polls misrepresenting voter opinion have been circulated to try and justify these flawed policies. These polls fail to educate voters on the policy arguments and trade-offs and consistently ignore voters’ true concerns, as well as patient voices speaking out against these types of proposals.

  • Did the Oncology Care Model produce cost savings?

    The answer is ‘yes’, but the magnitude of these savings are relatively small and more than offset by additional OCM program costs. Keating et al. (2021) writes: In this exploratory difference-in-differences study of Medicare fee-for-service beneficiaries with cancer undergoing chemotherapy (483 310 beneficiaries with 987 332 episodes treated at 201 OCM participating practices and 557 354 beneficiaries with […]

  • Journalists Offer Primers on Medicare Open Enrollment and Death Benefits Amid Covid

    KHN contributing writer and former columnist Michelle Andrews discussed on Newsy on Tuesday how unvaccinated workers risk losing the death benefits they would have otherwise received if they die of covid-19. Click here to watch Andrews on Newsy Read Andrews’ “Unvaccinated? Don’t Count on Leaving Your Family Death Benefits“ KHN chief Washington correspondent Julie Rovner […]

  • CMS scraps coverage rule for breakthrough devices

    The agency decided to rescind a rule by the previous administration where Medicare would be required to cover breakthrough devices for up to four years after they receive FDA approval or clearance. CMS said it made the change to address safety concerns with the policy.

  • Making medicines more affordable: Modernizing Medicare

    Common-sense reforms can help ensure everyone benefits from America’s engine of innovation and receives the care they need and deserve. In this series, we’re taking a closer look at PhRMA’s advocacy efforts to make medicines more affordable, part of our patient-centered agenda which aims to lower barriers between our industry’s medical innovations and patients who need them. 

  • La inscripción de Medicare es temporada abierta para estafadores

    Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. Sin embargo, funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir […]

  • KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congress appears to be making progress on its huge social spending bill, but even if it passes the House as planned the week of Nov. 15, it’s […]

  • Researcher: Medicare Advantage Plans Costing Billions More Than They Should

    Switching seniors to Medicare Advantage plans has cost taxpayers tens of billions of dollars more than keeping them in original Medicare, a cost that has exploded since 2018 and is likely to rise even higher, new research has found. Richard Kronick, a former federal health policy researcher and a professor at the University of California-San […]

  • Medicare’s Open Enrollment Is Open Season for Scammers

    Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or […]

  • Oak Street Health stock drops on DOJ investigation

    In its earnings statement, the company disclosed that it received a civil investigative demand from the Department of Justice. Specifically, the agency was looking for information on Oak Street’s relationships with third-party marketing agents and transportation services. 

  • Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap

    Medicare’s annual open-enrollment season is here and millions of beneficiaries — prompted by a massive advertising campaign and aided by a detailed federal website — will choose a private Medicare Advantage plan. But those who have instead opted for traditional Medicare face a critical decision about private insurance. Too often the import of that choice […]

  • Despite Restraints, Democrats’ Drug Pricing Plan Could Still Aid Consumers

    The Medicare prescription drug pricing plan Democrats unveiled this week is not nearly as ambitious as many lawmakers sought, but they and drug policy experts say the provisions crack open the door to reforms that could have dramatic effects.  Tamping down drug expenses has been a longtime rallying cry for consumers beset by rapidly rising prices. Although people […]

  • Democrats Plan to Expand Medicare Hearing Benefits. What Can Consumers Expect?

    President Joe Biden’s mammoth domestic spending bill would add hearing benefits to the traditional Medicare program — one of three major new benefits Democrats had sought. The Biden administration appears to have fallen short of its ambition to expand dental and vision along with hearing benefits. Sen. Bernie Sanders (I-Vt.) and other progressives have long […]

  • KHN’s ‘What the Health?’: Compromise Is Coming — Maybe

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Democrats on Capitol Hill hope they are nearing the finish line in their months-long quest to enact President Joe Biden’s social spending agenda. After briefly dropping from […]

  • Few Acute Care Hospitals Escaped Readmissions Penalties

    Preventable rehospitalization of the nation’s older adults has proved a persistent health and financial challenge for the U.S., costing Medicare hundreds of millions of dollars each year. Various analyses have found many readmissions within a month of discharge might have been avoided through better care and more attention paid to the patients after they left […]

  • What they are saying: Government price setting for medicines is not the answer

    America’s biopharmaceutical companies continue to voice the dangers of current proposals in Washington that would allow the government to set prices for medicines. While it’s being called government “negotiation,” it really is government price setting, and it would have significant ramifications for research and development efforts that fuel innovation, sacrificing by a conservative estimate more […]

  • Democrats agree last-ditch deal to save drug pricing plans

    Under fire for abandoning a plan to allow Medicare to negotiate drug pricing, Democrats in the Senate have reached an agreement that could see the policy reintroduced in the Biden administration’s ‘build back better’ spending proposals. A new stripped back proposal has won over rebel Democrats whose earlier opposition led the plan to be shelved, […]

  • A State Roadmap To Successfully Deploy Medicare Modularity (MMIS)

    Victor Sterling, Principal Industry Consultant at SAS In 2010, the Affordable Care Act ushered in a new era for Medicaid Modularity, an approach anchored by breaking down large, monolith systems into smaller, more nimble and self-contained modules that can de-risk healthcare delivery and unlock innovation. More broadly, Medicaid Modularity is about improving states’ Medicaid Management […]

  • A Record 3,834 Medicare Advantage Plans Will be Available in 2022, Up 8 Percent From 2021, While the Number of Medicare Part D Stand-Alone Plans is Decreasing Mainly Due to Firm Consolidations

    A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s an increase of 8 percent from 2021, and the largest number of plans available in more than a decade. At the same time, the number of Medicare Part D stand-alone…More

  • Medicare Advantage 2022 Spotlight: First Look

    For 2022, the average Medicare beneficiary has access to 39 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 59 percent will charge no premium in addition to the monthly Medicare […]

  • Medicare Part D: A First Look at Medicare Prescription Drug Plans in 2022

    This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D drug plans […]

  • On behavioral change, health and age

    A Health Affairs article (Meyer 2021) discusses the potential benefits of Medicare Diabetes Prevention Programs (MDPP). MDPP aims to reduce patient weight and prevent patients from becoming diabetic. Commenting on her Medicare clientele enrolled in the program, one instructor noted: “I’ve seen a lot of Medicare people do really well with the program because they […]

  • Journalists Explore Shadow Pandemics of Hospital Violence and Grieving Children

    KHN Midwest correspondent Bram Sable-Smith discussed how the pandemic has exacerbated violence in hospitals on Wisconsin Public Radio’s “The Morning Show” on Wednesday. Click here to hear Sable-Smith on “The Morning Show“ Read Sable-Smith’s “‘Are You Going to Keep Me Safe?’ Hospital Workers Sound Alarm on Rising Violence” KHN chief Washington correspondent Julie Rovner discussed […]

  • What’s Scarier Than Covid? Halloween Health Haikus

    Boo that we couldn’t treat all the readers participating in our third annual KHN Halloween Haiku Contest to their moment of gory glory. Your entries — like our health care system — ranged from frighteningly complex to haunting. And, based on a review by our panel of never-say-die judges, here’s the winner and a sampling […]

  • Medicare Punishes 2,499 Hospitals for High Readmissions

    The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals. In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities. The average penalty is a 0.64% reduction in payment […]

  • Democrats’ Plans to Expand Medicare Benefits Put Pinch on Advantage Plans’ Funding

    “Did you think we wouldn’t notice?” an older woman says, speaking into the camera. “You thought you could sneak this through?” an older man later adds. Others warn that Washington is “messing with” their Medicare Advantage health coverage and trying to raise their premiums. But the television ad, paid for by Better Medicare Alliance, a […]

  • Look Up Your Hospital: Is It Being Penalized By Medicare?

    Under programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of infections and patient injuries. For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The […]

  • 3 States Limit Nursing Home Profits in Bid to Improve Care

    Nursing homes receive billions of taxpayers’ dollars every year to care for chronically ill frail elders, but until now, there was no guarantee that’s how the money would be spent. Massachusetts, New Jersey and New York are taking unprecedented steps to ensure they get what they pay for, after the devastating impact of covid-19 exposed […]

  • Part D Senior Savings Model: What is it?

    If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? Well it is. Medicare Part D beneficiaries have a deductible, then the standard coverage phase with 25% cost sharing, then a coverage gap where beneficiaries pay 25% of cost (manufacturers […]

  • CMMI and its revised strategy

    Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3 […]

  • Ask About Adherence: CMS finds medication adherence saved Medicare up to $46.6B in avoided health care costs between 2013 and 2018

    A recent Centers for Medicare & Medicaid Services (CMS) study found that medication use is improving among seniors and vulnerable beneficiary populations. Better adherence to medicines used to treat common chronic conditions such as high cholesterol, high blood pressure and diabetes is estimated to have saved the Medicare program between $27B and $46.6B in avoided health care […]

  • Watch: Going Beyond the Script of ‘Dopesick’ and America’s Real-Life Opioid Crisis

    KHN and policy colleagues at our parent organization KFF teamed up with Hulu for a discussion of America’s opioid crisis, following the Oct. 13 premiere of the online streaming service’s new series “Dopesick.” The discussion explored how the series’ writers worked with journalist Beth Macy, author of the book “Dopesick: Dealers, Doctors, and the Drug […]

  • An Overview of the Medicare Part D Prescription Drug Benefit

    This fact sheet includes the latest information and data about the Medicare Part D prescription drug benefit, including current plan information, the standard benefit parameters, low-income assistance, the latest available enrollment data, and Part D program spending and financing.

  • What is Kaiser Family Foundation up to?

    For years, Kaiser Family Foundation (Kaiser) has reminded lawmakers that Americans are opposed to government “negotiation” in drug pricing should it lead to less access to medicines and destroy future innovation. Sadly, in a new poll, Kaiser is joining the partisan fray and political advocacy groups who are trying desperately to build congressional support for […]

  • Bamboo Health ACOs Generate $1B+ in Medicare Shared Savings Program

    What You Should Know:  – Following the National Association of Accountable Care Organizations (ACOs) announcement of 2020 data detailing the Medicare Shared Savings Program (MSSP), Medicare’s largest alternative payment model, Bamboo Health, formerly Appriss Health and PatientPing, announced its national network of ACOs generated over $1 billion in total shared savings.  – Bamboo Health’s ACO […]

  • The Public Weighs In On Medicare Drug Negotiations

    This data note from the latest KFF Health Tracking Poll explores the public’s views on Medicare drug price negotiation, including how arguments on both sides impact support and opposition; confidence in leaders to do the right thing on drug pricing; and experiences with prescription drug costs.

  • Large Majorities Across Parties Favor Allowing the Federal Government to Negotiate Drug Prices, Even After Hearing Common Arguments About It

    Most of the Public Lacks Confidence that President Biden, Congressional Democrats or Republicans Will Do the Right Thing on Drug Prices Allowing the federal government to negotiate with drug companies to lower drug prices for Medicare beneficiaries and people enrolled in private plans – a key cost-saving proposal in the Democrats’ massive reconciliation bill –…More

  • The Public Backs Medicare Rx Price Negotiation Even After Hearing Both Sides’ Views

    As Congress debates cutting prescription drug costs, a poll released Tuesday found the vast majority of adults — regardless of their political party or age — support letting the federal government negotiate drug prices for Medicare beneficiaries and those in private health insurance plans. The argument that pharmaceutical companies need to charge high prices to […]

  • GAO Report on MIPS

    The Government Accountability Office (GAO) last week published a report evaluating the Merit-based Incentive Payment System (MIPS). MIPS is an approach for CMS to pay physicians caring for Medicare beneficiaries based not just on volume but on value. MIPS evaluates provider value along four dimensions: (1) quality, (2) improvement activities, (3) promoting interoperability, and (4) […]

  • Mandatory Vaccines for Health Care Workers Might Upend Nurses’ Training

    Kaitlyn Hevner expects to complete a 15-month accelerated nursing program at the University of North Florida in Jacksonville in December. For her clinical training this fall, she’s working 12-hour shifts on weekends with medical-surgical patients at a hospital. But Hevner and nursing students like her who refuse to get vaccinated against covid-19 are in an […]

  • An Ad’s Charge That Price Haggling Would ‘Swipe $500 Billion From Medicare’ Is Incorrect

    “These guys [insurance companies and Washington bureaucrats] are working together to swipe $500 billion from Medicare to pay for Pelosi and Schumer’s out-of-control spending spree.” Video advertisement from the 60 Plus American Association of Senior Citizens The advertisement opens with a doctor sitting across from his patient and holding a prescription drug pill bottle. “You […]

  • KHN’s ‘What the Health?’: The Autumn of Democrats’ Discontent

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Democrats in Congress and the White House are feverishly negotiating to pass as much of President Joe Biden’s domestic agenda as they can agree on, even as […]

  • Industry leaders discuss the impact of the drug pricing debate

    This month, PhRMA hosted a media briefing with leaders within the biopharmaceutical industry to discuss the dangers of current proposals on government price setting, while also sharing alternative solutions that would lower patients’ out-of-pocket costs while protecting access to medicines and the discovery of future cures and treatments. Speakers included:

  • InnovAge CEO Maureen Hewitt: PACE Tailwinds Stronger Than Ever

    InnovAge (Nasdaq: INNV) went public earlier this year with a $350 million IPO. It has since set its sights on expansion. The largest Program of All-Inclusive Care for the Elderly (PACE) organization in the country, InnovAge is bullish on its ability to do just that, thanks to both internal confidence and also external, regulatory tailwinds. […]

  • Five reasons tying VA prices to Medicare Part D misses the mark

    Some members of Congress are considering a government “negotiation” plan that would tie medicine prices in Medicare to those in the U.S. Department of Veterans Affairs (VA). This misguided approach is just the latest in a series of government price-setting proposals that threaten patients’ access to medicines and future innovation.

  • Many Medicare Beneficiaries Face High Out-of-Pocket Costs for Dental and Hearing Care, Whether in Traditional Medicare or Medicare Advantage

    Many Medicare beneficiaries face high annual out-of-pocket costs for dental and hearing care — services that generally aren’t covered in traditional Medicare, but typically are covered by Medicare Advantage plans though the scope and value of these benefits vary, finds a new KFF analysis. The analysis shows that, among beneficiaries who used each type of…More

  • Increasing LTSS Access Could Cost Up to $12.8 Billion Per Year

    Access to long-term services and supports (LTSS) in the U.S. remains limited, which currently puts seniors in need in a bind. Their options are often such: spend down on savings and assets in order to qualify for Medicaid, or rely on unpaid family care or other informal services. A new study from the Washington, D.C.-based […]

  • Why Senior-Focused Primary Care Centers Are Reaching into the Home

    More and more primary care centers have chosen to specialize in serving seniors. In particular, companies such as CareMax Inc. (Nasdaq: CMAX), VillageMD and Humana Inc., mainly through its CenterWell Senior Primary Care arm, have all solidified their spots in the senior care sector by becoming a one-stop-shop for geriatric services. Sign up for HHCN […]

  • Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans

    Nevada dentist David White has seen diseased and rotted teeth in the mouths of patients who routinely put off checkups and avoided minor procedures such as fillings. While dental phobia is a factor, White said, the overriding reason people avoid treatment is cost. To help patients lacking dental insurance, White in 2019 started offering a […]

  • KHN’s ‘What the Health?’: Much Ado About Drug Prices

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congressional Democrats are finding it harder to actually write legislation to lower drug prices than it is to make promises about it. But the drug price provisions of the $3.5 trillion social-spending bill […]

  • Older Americans Overwhelmingly Support Choose Home Care Act

    The vast majority of older Americans want to age in place, several past surveys have found. Unsurprisingly, that desire has translated into overwhelming support for the Choose Home Care Act. Introduced in July by Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.), Choose Home is legislation designed to give nursing home-eligible Medicare beneficiaries more options […]

  • Justice Department Targets Data Mining in Medicare Advantage Fraud Case

    The Justice Department has accused an upstate New York health insurance plan for seniors and its medical analytics company of cheating the government out of tens of millions of dollars. The civil complaint of fraud, filed late Monday, is the first by the federal government to target a data mining company for allegedly helping a […]

  • 2021 Medicare Trustees Report

    The 2021 Medicare Trustees Report–formerly known as the “Annual Report of the Boards of Trustees of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund“–had some grim news. Expenditures ($925.8 billion) exceeded revenues ($899.9 billion) in 2020. More worrying, the estimated depletion date for the Medicare (i.e., Hospital Insurance) trust […]

  • Report: Medicare trust fund still expected to run out by 2026

    The latest report from the Medicare Board of Trustees shows that the health insurance trust fund, also known as Medicare Part A, will run out in a mere five years, which is in line with reports released in 2018, 2019 and 2020, indicating that the Covid-19 pandemic has not hastened the fund’s depletion.

  • Ochsner Health Launches Fall Prevention Pilot Program to Medicare Advantage Members

    What You Should Know:  – Ochsner Health and innovationOchsner (iO) have partnered with Bold, an evidence-based, digital exercise platform for older adults aimed at reducing falls and improving health outcomes. – The Bold platform is one of five interventions in the Ochsner Connected Stability pilot fall prevention and monitoring programs focused on helping Medicare Advantage […]

  • Recent polling misrepresents public support for Medicare “negotiation”

    Proponents of government price setting often misrepresent voters’ opinions on support for allowing the federal government to “negotiate” drug prices. This includes recent polling from advocacy firms like the Alliance for Retired Americans/Lake Research Partners that fails to reveal voters’ true health care priorities and concerns with government price setting, or so-called “negotiation.”

  • How CommonSpirit Reduced Medicare Spending by $136M

    CommonSpirit Health carved out $136 million in savings to Medicare for 2020, while also improving overall outcomes for hundreds of thousands of beneficiaries, the company recently announced. CommonSpirit Health is a participant in the Medicare Shared Savings Program (MSSP), which began back in 2012 after being designed by the U.S. Centers for Medicare and Medicaid […]

  • What they’re saying: Patient advocates want to protect Medicare from government interference

    For seniors and people with disabilities, Medicare Parts B and D provide important access to lifesaving medicines. Unfortunately, some in Congress are proposing changes to Medicare under the guise of “negotiation,” meaning the government can set the price of medicines. But experts agree access to current and future medicines for Medicare beneficiaries is threatened when […]

  • Impact of Medicare Pay-for-Performance Program for Surgical Procedures on Cost and Outcomes

    In 2008, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Conditions Present on Admission (HAC-POA) program. The goal of this program was to reduce the frequency of high-cost complications among Medicare beneficiaries. The mandatory program penalized hospitals as it would no longer reimburse them for treating of preventable complications that developed during […]

  • Readers and Tweeters Ponder Vaccines and Points of Fairness

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. Higher Insurance Rates for the Unvaccinated? Snuff Out That Idea This is about Dr. Elisabeth Rosenthal’s comments on “All In With Chris Hayes” (“Analysis: Don’t Want a Vaccine? Be Prepared to […]

  • Biden’s No-Jab-No-Job Order Creates Quandary for Nursing Homes

    President Joe Biden’s edict that nursing homes must ensure their workers are vaccinated against covid-19 presents a challenge for an industry struggling to entice its lowest-paid workers to get shots without driving them to seek employment elsewhere. Although 83% of residents in the average nursing facility are vaccinated, only 61% of a home’s workers are […]

  • KHN’s ‘What the Health?’: Booster Time

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. As covid-19 cases in the U.S. continue to rise, the Biden administration is countering with new strategies. The latest efforts include preparing for vaccine boosters starting this […]

  • Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019

    The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis. The Medicare Advantage spending includes the cost of extra…More

  • KHN’s ‘What the Health?’: The Senate Acts

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Senate has set the stage for a busy fall that will include debate on a broad array of health issues, such as prescription drug prices, Medicare […]

  • Myth vs. fact: Polling and Medicare “negotiation”

    As some in Washington consider legislation related to prescription medicines and how to best help Americans manage health care costs, government “negotiation” of prescription medicines within Medicare continues to be debated. The concept of government-led negotiation is highly misleading – and there are other, more common-sense policy solutions that are in the better interest of […]

  • How Would Drug Price Negotiation Affect Medicare Part D Premiums?

    Proposals to allow the federal government to negotiate prescription drug prices, such as H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, aim to lower out-of-pocket drug costs for Medicare beneficiaries and private plan enrollees and achieve savings for Medicare. This data note estimates average premium savings attributable to the negotiations provision of […]

  • US telemedicine company owner charged with $784m fraud

    A jury in the US has charged a Florida man who owns multiple telemedicine companies in connection with a massive healthcare scam that involved a massive $784 million in fraudulent claims being submitted to Medicare. Creaghan Harry (53) is accused of conspiracy to commit health care fraud and wire fraud, and four counts of income […]

  • Why Doesn’t Medicare Cover Services So Many Seniors Need?

    Sorry, Joe Namath. Despite what you keep saying in those TV ads, under Medicare, seniors are not “entitled to eliminate copays and get dental care, dentures, eyeglasses, prescription drug coverage, in-home aides, unlimited transportation and home-delivered meals, all at no additional cost.” But if Democratic lawmakers in Congress have their say, seniors could soon be […]

  • 2+2=? Senate Uses Murky Math as It Shelves Drug Pricing Rule to Fund Infrastructure

    The Senate’s release of its bipartisan infrastructure plan signals that lawmakers are poised to throw former President Donald Trump’s belated bid to lower Medicare drug prices under the bus — not to mention trains, bridges, tunnels and broadband connections. That’s because the massive spending bill is the first of two likely to at least delay […]

  • Celebrating Medicare’s 56th anniversary

    For 56 years, Medicare has helped pay for medical care for Americans over the age of 65, as well as younger Americans with certain medical needs. Today marks Medicare’s anniversary and to celebrate, we are reflecting on the history of the program that benefits more than 60 million Americans.

  • Pfizer Court Fight Could Legalize Medicare Copays and Unleash ‘Gold Rush’ in Sales

    Three years ago, pharma giant Pfizer paid $24 million to settle federal allegations that it was paying kickbacks and inflating sales by reimbursing Medicare patients for out-of-pocket medication costs. By making prohibitively expensive medicine essentially free for patients, the company induced them to use Pfizer drugs even as the price of one of those medicines, […]

  • Medicare vaccine coverage (including how the COVID-19 vaccines are covered)

    How does Medicare cover vaccines? Are the paid for by Medicare Part B or Part D? MedPAC’s June 2021 report provides a nice overview. Medicare covers vaccines under Part B and Part D. Part B covers vaccines for influenza, pneumococcal disease, hepatitis B (for patients at high or intermediate risk), and coronavirus disease 2019 (COVID-19), […]

  • 10 FAQs on Prescription Drug Importation

    These FAQs discuss recent efforts related to prescription drug importation, the history of this approach, challenges that previous efforts to carry out importation proposals have faced, and stakeholder views.

  • Medicare and Dental Coverage: A Closer Look

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental […]

  • Despite Formidable Challenges, PACE Leaders Keep Expansion Dreams Alive

    The Program of All-Inclusive Care for the Elderly (PACE) concept has gained significant business and policy momentum over the past several months, with recent research also highlighting just how successful programs were at avoiding COVID-19 deaths compared to other care settings. Despite that traction and the model’s clear benefits, PACE still faces a long list […]

  • Government “negotiation” could have devastating consequences for Medicare enrollees

    Some members of Congress are considering significant changes to Medicare that could have a devastating effect on millions of Americans. Proponents call these changes government “negotiation,” but what they are actually proposing is anything but that. These politicians want to repeal a key provision of the Medicare Part D program that protects robust coverage and […]

  • What’s the Latest on Medicare Drug Price Negotiations?

    In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price of prescription drugs for Medicare and private payers. This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal […]

  • Protecting Medicare from government interference

    For more than a decade, Medicare Part D has provided seniors and people with disabilities with affordable and comprehensive prescription medicine coverage. Several surveys show that more than 9 in 10 Part D enrollees are satisfied with their coverage, helping tens of millions of patients manage a number of chronic and life-threatening conditions, including diabetes, […]

  • Sen. Wyden: $3.5T Budget May Have to Trim but It Can Set a Path to ‘Ambitious Goals’

    Exactly what American health care will look like if Democrats can pass their $3.5 trillion spending plan is unclear, but the senator negotiating its health-related provisions hopes what emerges will be dramatic: the first complete health care system for older Americans and significantly reduced costs for everyone else. “We are setting very, very ambitious goals,” […]

  • Data shows voters strongly support protecting access to their medicines

    In our current health care system, the Medicare Part D program helps ensure seniors and people with disabilities have access to the prescription medicines they need. While more than 90% of seniors are very satisfied with their Part D prescription drug coverage and want to protect it, we also must tackle rising out-of-pocket costs for […]

  • KHN’s ‘What the Health?’: Here Comes Reconciliation

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The expansion of health benefits is a major piece of the tentative budget deal reached this week by Democrats in Congress. They plan to press ahead — […]

  • Senate Democrats’ Plan Boosts Spending on Medicare, ACA Subsidies, Long-Term Care

    The budget package Democrats are assembling in Congress would likely provide the biggest jolt to the American health care system since the passage of the Affordable Care Act in 2010, according to sources familiar with work on the plan. Democrats in the Senate announced Tuesday night that they had reached a framework for a $3.5 […]

  • CMS proposes to cover mental health virtual visits through 2022

    In the 1,747-page rule, which will be finalized later this year, CMS proposes expanding access to telehealth for behavioral healthcare, including for the first time allowing Medicare to pay for mental health virtual visits when they are provided by rural health clinics and federally qualified health centers and letting providers offer audio-only telehealth visits for […]

  • As Congress Wrestles With Plans to Expand Medicare, Becerra Says Any One Will Do

    The Biden administration will support whatever expansions to Medicare Congress is willing to make, Health and Human Services Secretary Xavier Becerra said Tuesday. Democratic lawmakers on Capitol Hill are working on plans both to add benefits to the health program for seniors and to lower its eligibility age from 65 to 60. But the efforts […]

  • CMS considers coverage of Biogen’s costly new Alzheimer’s drug

    CMS plans to review and determine coverage for Biogen’s Aduhelm, the first new Alzheimer’s disease treatment in decades. But the jury is still out on the drug’s effectiveness. Not to mention, its hefty price tag — $56,000 — could drive up Medicare spending.

  • US starts review of Aduhelm coverage amid fears of Medicare hit

    The US government has started a review of how Biogen and Eisai’s pricey new Alzheimer’s disease therapy Aduhelm will be covered by Medicare, to see if a national strategy needs to be adopted. At the moment, the coverage for $56,000-a-year Aduhelm (aducanumab) is currently determined at the local level by Medicare administrative contractors representing 12 […]

  • Drugmakers’ Spending on Stock, Dividends and Executive Pay Exceeds Research, Democrats Say

    The largest drug companies are far more interested in enriching themselves and investors than in developing new drugs, according to a House committee report released Thursday that argues the industry can afford to charge Medicare less for prescriptions. The report by the House Oversight and Reform Committee says that contrary to pharmaceutical industry arguments that […]

  • MedPAC report on alternative payment models

    In 2021, CMS expects to operate 12 alternative payment models (APMs) offering 25 distinct tracks for providers to choose from that involve different payment options and risk arrangement… providers serving about 20 percent of Medicare beneficiaries participate in this APM That is a quote from a June 2021 MedPAC report on CMS APM’s serving Medicare […]

  • Paying Billions for Controversial Alzheimer’s Drug? How About Funding This Instead?

    If you could invest $56 billion each year in improving health care for older adults, how would you spend it? On a hugely expensive medication with questionable efficacy — or something else? This isn’t an abstract question. Aduhelm, a new Alzheimer’s drug approved by the Food and Drug Administration last month, could be prescribed to […]

  • KHN’s ‘What the Health?’: Un-Trumping the ACA

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration this week proposed a series of changes aimed at boosting insurance enrollment under the Affordable Care Act, undoing changes made by the Trump administration […]

  • ‘Extensive’ Proposed Rule Sets Stage for Value-Based Purchasing, PDGM Adjustments

    The U.S. Centers for Medicare & Medicaid Services (CMS) released its FY 2020 home health proposed payment rule on Monday, while simultaneously announcing plans for the nationwide expansion of the industry’s value-based purchasing demo. While just a few days have gone by, home health stakeholders have already started to zero-in on several key areas — […]

  • Medicare “negotiation” proposals threaten Americans’ access to medicines

    While more than 90% of seniors and people with disabilities report that they are very satisfied with their Medicare Part D prescription drug coverage, they also acknowledge concerns with rising out-of-pocket costs. It is no surprise that this has been a recurring discussion on Capitol Hill with many putting forth proposals aimed at lowering the […]

  • Former CMMI director’s new company will focus on value-based rural healthcare

    Main Street Health, launched by former Center for Medicare & Medicaid Innovation Director Brad Smith, aims to provide value-based care solutions in rural America. The company’s first step will be to partner with primary care clinics, urgent care centers and independent pharmacies to implement a program that will coordinate care for seniors.

  • KHN’s ‘What the Health?’: The ACA Lives

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. For the third time in nine years, the Affordable Care Act has survived a constitutional challenge at the Supreme Court. In a 7-2 decision, the court ruled […]

  • HHS Issues New Reporting Requirements, Deadlines for Provider Relief Fund Recipients

    Home health providers may have some additional financial aid in the not-too-distant future, as the federal government reportedly inches closer toward disbursing another round of CARES Act funds. As they wait for details, home health providers and other Medicare-reimbursed organizations on Friday received new reporting requirements and deadlines for the COVID-19 relief dollars they received […]

  • Innovaccer Unveils Health Plan Analytics Tool to Give a Comprehensive View of Over 700 Medicare Advantage Plans

    What You Should Know:  –Innovaccer Inc., a leading healthcare technology company, recently launched its Health Plan Analytics tool, which provides a comprehensive view of health plan performance across the country.  –With this tool, payers can identify the quality parameters where they lag and determine the performance threshold to attain satisfactory ratings and enrollment. In addition, […]