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Tag: Insurance: Medicare

Using negotiated prices and a defined formulary

Negotiated Prices, Formulary Could Cut Medicare Rx Spending

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Findings based on analysis of 31 different insulin products using 2017 VA formulary and prices
Hospitals caring for neighborhoods with high levels of disadvantage may have lower hospital ratings due to social risk factors in the community

Neighborhood Disadvantage Impacts Hospital Quality Ratings

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Hospitals serving communities with higher social risk have lower-quality ratings
Following Medicare payment reform for dialysis

Use of Peritoneal Dialysis Up Since Medicare Payment Reform

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More patients initiated peritoneal dialysis, switched to peritoneal dialysis after PPS initiation
The newly overhauled Medicare prescription plan finder can direct unsuspecting users to coverage that is much more expensive than necessary

New Medicare Online Drug Plan Finder Might Lead to Higher Cost

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Program experts and people who help with sign-ups say the tool can obscure out-of-pocket costs
A bipartisan Senate bill that would curb prescription drug costs is being backed by the Trump administration as a new poll shows that many Americans think the White House has done little to tackle the issue.

Bipartisan Bill to Curb Drug Costs Backed by White House

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Senate bill does not give Medicare bargaining power but would cap out-of-pocket payments by beneficiaries
Seriously ill Medicare enrollees experience considerable financial distress

Seriously Ill Medicare Beneficiaries Face Financial Hardship

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Majority of respondents rely on help from family and friends, at considerable cost
Receiving medical care from fraud and abuse perpetrators

Outcomes Poor With Medical Care From Fraud, Abuse Perpetrators

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Mortality and emergency hospitalization rates higher in Medicare beneficiaries with FAP exposures
Medicare graduate medical education payments increased significantly from 2000 to 2015

2000 to 2015 Saw Increase in Medicare GME Payments

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Increase mainly due to indirect payments, primarily inpatient costs rather than resident-to-bed ratio
Revision of decades-old Medicare rules meant to prevent fraud has been proposed by the Trump administration.

Medicare Fraud-Prevention Rules to Be Revised

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Current rules make it difficult for hospitals and doctors to work together, officials say
There are large disparities between Medicaid and Medicare reimbursement rates for eight spine procedures

Medicaid Pays 75 Percent of What Medicare Pays for Spine Surgeries

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Study authors report differences in reimbursement for certain procedures may impact access to care