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Tag: Insurance: Medicare

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
Medicare fee-for-service beneficiaries were less likely to die in acute care hospitals in 2015 than in 2000

Decline in Medicare Patients Who Die in Acute Care Hospitals

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2000 to 2015 also saw increase in ICU use in last month of life, deaths in home or community setting
Introducing the Comprehensive Primary Care Initiative

Comprehensive Primary Care Initiative Improves Care Delivery

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Reduction in Medicare spending associated with CPC was not enough to cover care management fees
Current publicly reported measures may not be good surrogates for overall hospital quality related to 30-day readmissions

Condition Readmission Measures Don’t Reflect Overall Quality

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Differ from non-Medicare patients with same conditions, Medicare patients with unreported ones