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What We’re Reading: Case for Cost-Free Preventive Services; Medicare Pay Bump; MA Home Health Care Disparities
Appeals court to review ruling wiping out some cost-free preventative services; a new legislation aims to boost reimbursement rates for medical providers; changes to coverage may limit elderly home care access
Appeals Court Reviews Ruling Out Cost-Free Preventive Services
The 5th US Circuit Court of Appeals will hear arguments in the case over a provision that requires insurers cover preventive care services at no costs to patients, under an Affordable Care Act (ACA) mandate, according to CNN. The court is set to review a Texas judge’s ruling that wiped away that requirement, which is currently paused until under the verdict of the appeals court. The decision is likely to have far-reaching implications for both health care policy and the ongoing debate over the future of the ACA.
Doctors Applaud Proposed Medicare Pay Increase
Starting March 9, 2024, doctors will receive a 1.68% pay increase from Medicaid under a new deal struck over the weekend by Congress, according to Stat. The proposed legislation seeks to address longstanding concerns about low payment rates and reforms for the practice of using pharmacy benefit managers. If passed, the bill could improve access to care for Medicare beneficiaries and help alleviate financial strains on medical practices nationwide.
MA Plans Set to Impose Limits on Home Health Services
Medicare Advantage (MA) plans are poised to restrict access to home health services, sparking worries among elderly populations, according to Axios. A recent study in JAMA Health Forum found that patients with MA plans had less home health care and worse outcomes than those on Medicare. Advocates fear that such changes may exacerbate health disparities for those who are likelier to live alone with less care and often don’t need care until they are in dire medical situations.
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Traditional Medicare Supplemental Insurance and the Rise of Medicare Advantage
May 7th 2024Rising Medicare Advantage enrollment occurred alongside declines in enrollment in traditional Medicare with employer-sponsored supplemental coverage and traditional Medicare without supplemental coverage.
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