Fraud in the Medicare home health benefit has been a recent focus of the Administration's.
But how do we eliminate fraud while making benefits easily accessible to those who need them?
It's a tough - but essential - regulatory balance.
@Health_Affairs
https://t.co/1Yh1SziR1j
The TrumpRx launch highlights that even Medicare beneficiaries may use sites like this, even though they don't take insurance.
About 1 in 5 Medicare beneficiaries said they had used GoodRx or other drug discount site in the past yr - mostly to lower costs.
https://t.co/0FpiDWb2RY
Medicare beneficiaries will be able to choose from 10 prescription drug plans (PDPs), on average, in 2026 -- 4 fewer than in 2025.
Fewer plans will be available in every state.
Choice matters because coverage is only useful if it makes your drugs affordable at your pharmacy.
After the ACA, experts predicted Medicare Advantage enrollment would steeply decline -- but the opposite happened.
In @Health_Affairs Cori Uccello & I explain why this happened.
It's a story of payment incentives, structural barriers & demographic changes.
https://t.co/2sUPAIcoky
#MedicareAdvantage defied expectations w rapid growth after #ACA enactment. Today in @Health_Affairs, co-authors @GretchJacob & @Actuary_dot_org Sr Health Fellow Cori Uccello examine why – and explore reform options to further improve MA for beneficiaries. https://t.co/LEQUD10kgr
@MelindaBBuntin@Actuary_Dot_Org@JHU_CHSPM@JohnsHopkinsSPH@JHU_BDPs@JHUCarey We found that all beneficiaries could be provided:
- limit on out-of-pocket costs
- dental, vision & hearing care
- lower Part D premiums
- some coverage of over-the-counter medicines &
- more mental health coverage
for less than what's spent on Medicare Advantage plans' rebates.
1 in 5 Medicare beneficiaries have said they got their prescriptions last year through online drug discount businesses, like GoodRx, primarily to lower their costs.
But do they know this spending doesn’t count toward their Part D out-of-pocket limit?
https://t.co/0FpiDWbAHw
In this Viewpoint, @DavidBlumenthal and @GretchJacob explore the affordability of health care services for Medicare Advantage vs traditional Medicare beneficiaries. https://t.co/V5HUPuIyJw
Multiple surveys have shown few differences in the affordability of care for Medicare Advantage beneficiaries vs those in traditional Medicare.
In our new article, we discuss why this may the case and possible explanations. @DavidBlumenthal@JAMA_current
https://t.co/Sa6LtR5gTx
"Because of the research and analytical skills I gained at HPM, I was prepared to engage with policymakers in dynamic and rapidly evolving policy discussions,” says HPM PhD ’07 Alum & @CommonWealthFnd VP of Medicare @GretchJacob.
Read about her career: https://t.co/U9lvMP8yfd
ICYMI, we looked at survey responses from PCPs and found few differences in how care is delivered for Medicare Advantage vs traditional Medicare (TM) beneficiaries.
But it was interesting to see how few PCPs these days only see pts with TM (among those who see any Medicare pts)
The big challenge as Medicare Advantage continues to grow will be to ensure that the Medicare program provides affordable, high quality care, is efficient, honest and free from abuse, and meets beneficiaries’ needs.
ICYMI, @DavidBlumenthal and I discuss the growing and changing landscape of private plans in Medicare for @NEJM
We lay out how the program works, how it compares to traditional Medicare, and what this growth means for Medicare and its enrollees.
https://t.co/AXzhPoWKMV
We don’t have solid answers to how MA compares to TM across important facets, incl. quality of care for high-need benes & the effects of prior auth and denials on outcomes & spending.
We also do not know to what degree plans’ supplemental benefits are used & valued by enrollees.