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Tag: Insurance: Medicare

Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs

Physician-Group ACOs Generate Medicare Savings

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Savings grow with longer participation and are significantly higher than hospital-integrated ACOs
Simplifying an internet-based decision support tool provided by the Centers for Medicare & Medicaid Services to help older adults make good plan choices in the Medicare prescription drug program could result in selection of lower-cost plans

Simplifying Medicare Plan Finder Improves Plan Selection

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Simplifying Plan Finder results in selection of lower-cost plans with no decrease in plan quality
Patients with prostate cancer receiving care in a Medicare-only setting are more likely to receive guideline-discordant imaging

Guideline-Discordant Prostate Cancer Imaging Up With Medicare

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Patients in VA and Medicare group, VA-only group less likely to receive guideline-discordant imaging
Under Medicare Part D

Out-of-Pocket Costs Similar for Infliximab, Infliximab-Dyyb

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Mean total costs per eight-week prescription and annually modestly lower for infliximab biosimilar
Geographic variation in the Medicare Advantage population exceeds that of traditional Medicare for use of skilled nursing facility and hospital care

Medicare, Med Advantage Health Care Use Differs Regionally

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Variation in skilled nursing facility, hospital care up in Medicare Advantage versus traditional Medicare
Promoting generic substitution and therapeutic interchange can save money compared with spending on brand-name combination medications

Generic Substitutes, Therapeutic Interchange Can Save Money

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Considerable savings estimated with use of generic substitutes for brand-name combo medications
Letters targeting high prescribers of quetiapine (Seroquel)

Peer Comparisons Can Decrease Risky Prescribing Patterns

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Meaningful, persistent drop in quetiapine prescribing seen, with no negative patient effects
Bundling of payments for five common medical conditions is not associated with changes in Medicare payments per episode or health outcomes

Bundling Doesn’t Cut Medicare Payments for Medical Conditions

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No changes in clinical complexity, length of stay, emergency visits, readmission, or mortality
In a letter sent to Administrator Seema Verma of the Centers for Medicare & Medicaid Services

Groups Urge CMS to Reconsider Suspending Risk Adjustment

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Twenty-eight medical organizations, including AMA, sent letter to Administrator Verma of CMS
Women enrolled in Medicare who undergo screening mammography seem to have increased awareness and use of other preventive screening measures

Mammography Use Tied to Other Preventive Tests in Older Women

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False-positive screening not tied to differences in receipt of other preventive services