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CMS proposes Medicare Advantage, drug rebate changes ...

CMS proposes Medicare Advantage, drug rebate changes

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CMS released a proposed rule on Thursday to make revisions to the Medicare Advantage program for contract year 2019, with an aim toward improving quality and affordability. The rule would implement certain provisions of the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act.

The number of plans...

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Medicare Advantage gets supplemental benefits flexibility ...

A CMS final rule gives Medicare Advantage plans additional flexibility in determining what supplemental benefits to offer certain beneficiaries, including for non-medical benefits like meal delivery and transportation.

The change, part of a broad Medicare payment rule for 2019, means that MA plans do not have to offer the same supplemental benefits to all chronically ill enrollees, but can tailor...

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CMS cost measure makes some Medicare Advantage plans ...

Some enrollees in Medicare Advantage plans are paying higher premiums due to a distortion in the way CMS determines payment for the plans, a new Health Affairs analysis finds.

MA payment is based on county-level benchmarks that average Medicare's per capita fee-for-service costs for Part A and Part B and then add them together. When beneficiaries opt out of Part B, that skews the cost measure,...

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Healthcare spending to reach 19.7% of GDP within a decade

Healthcare spending to reach 19.7% of GDP within a decade

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The increase is 1 percentage point above the expected GDP growth rate during the same time period. The data, newly published in Health Affairs , forecast healthcare...

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Related topics : medicare and private health insurance / health insurance medicare and medicaid / health insurance plans medicare / health insurance medicare / medicare and health insurance

Medicare ACOs saved $1.1B in 2017, CMS data show ...

New data from CMS found that the Medicare Shared Savings Program saved $314 million for Medicare after bonuses paid to accountable care organizations in 2017.

ACOs saved $1.1 billion total and CMS shared $780 million in savings with providers. There were 472 MSSP ACOs in 2017, and 60% saved money while 34% earned shared savings.

The average ACO achieved 92% on quality scores. The analysis found...

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Related topics : medicare savings program / cms medicare and medicaid innovation center / medicare fee for service program / centers for medicare and medicaid services cms / centers for medicare & medicaid services cms

CMS releases new Medicare Advantage data resource ...

CMS releases new Medicare Advantage data resource

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The agency is starting by releasing a preliminary version of the 2015 MA encounter data, with a final version of that data...

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Related topics : medicare advantage data / cms medicare advantage plans / cms medicare advantage / medicare advantage payments to health plans / cms medicare provider

Cigna can't resolve sanctions in time for 2017 Medicare ...

Cigna can't resolve sanctions in time for 2017 Medicare Advantage enrollment

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The issue stemmed from CMS' finding of "widespread and systemic failures" in Cigna's MA business, including deficiencies in its appeals and grievances processes, Part D formulary and benefit...

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Related topics : cigna medicare advantage sanctions / cigna medicare advantage plans / medicare part d enrollment period 2017 / cigna medicare part d plans 2016 / cigna medicare advantage

Azar talks list prices, mandatory Medicare pilots ...

The former Eli Lilly executive identified potential actions to lower drug prices, and an openness to mandatory pilot programs in some cases.

Despite opposition from Democrats, Azar is likely...

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Related topics : medicare part d drug discount program / medicare part d prescription drug program / medicare part d drug formulary / medicare part d drug program / medicare drug program cost

CMS updates hospital star ratings for the first time since ...

For the first time in more than a year, CMS updated its hospital star ratings. The agency collects the data from its Hospital Quality Initiative programs and the public can view the star ratings on the Hospital Compare website.

The American Hospital Association, which has requested a complete termination of the star ratings program in the past, along with America's Essential Hospitals, decried...

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Related topics : medicare hospital compare star rating / hospital medicare star ratings / cms medicare hospital compare / medicare hospital compare program / hospital medicare ratings