Medicare

The AJMC® Medicare compendium is a comprehensive resource for clinical news and expert insights on issues that affect Medicare beneficiaries with a focus on polypharmacy, reimbursement challenges, and other topics related to seniors.

Latest News

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Health Policy in Flux: Trump Administration Updates

March 28th 2025

Keep up with the latest moves made in health policy under President Donald Trump's second administration. This timeline will be updated as orders and policy progress.

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CGM Adherence and Costs Improve With DME Channel Over Pharmacy

March 26th 2025

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Texas Oncology to Roll Out Canopy for ePROs After Head-to-Head Pilot

March 18th 2025

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More Care Doesn't Equal Happier Patients in Traditional Medicare

March 17th 2025

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Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being

March 14th 2025

Examining the Benefit of an Innovative Enhanced Medication Therapy Management Model

In this series of articles, the authors present the MedWise Risk Score, an enhanced medication therapy management model, and its impact on medication safety reviews and health care outcomes.

AJMC Supplement Cover for Examining the Benefit of an Innovative Enhanced Medication Therapy Management Model

More News

Supreme Court
June 17th 2021

Supreme Court Tosses Challenge to ACA for Lack of Standing

Allison Inserro Christina Mattina
In a 7 to 2 decision, the Supreme Court ruled Thursday that the Affordable Care Act (ACA) will stand, as plaintiffs seeking to declare the law unconstitutional did not have standing.
Softer Alignment of Medicare ACOs May Still Lead to Higher Prices for Office Visits
June 7th 2021

Softer Alignment of Medicare ACOs May Still Lead to Higher Prices for Office Visits

Allison Inserro
The researchers created a model that simulated what would happen when health systems and providers began working together in Medicare accountable care organizations (ACOs) in arrangements that did not extend to outright mergers or acquisitions.
Davey Daniel, MD, Hematology and Medical Oncology Specialist, Tennessee Oncology.
June 4th 2021

Dr Davey Daniel on Lower Cost of Care Seen in Clinical Trials for OCM Enrollees

Davey Daniel, MD, hematology/medical oncology specialist, Tennessee Oncology, discusses findings of an abstract presented at ASCO 2021 showing a lower total cost of care paid by Medicare for episodes of care for patients in the Oncology Care Model (OCM) enrolled in clinical trials vs those receiving routine care.
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May 11th 2021

Variability of COPD Inhaler Coverage in Medicare Part D

Benjamin Wormser, MD Mariana P. Socal, MD, PhD, MPP, MSc Gerard Anderson, PhD
Although most Medicare Part D plans cover guideline-recommended outpatient chronic obstructive pulmonary disease (COPD) inhalers, the utilization controls applied to these therapies vary by plan type.
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May 6th 2021

Quality, Health, and Spending in Medicare Advantage and Traditional Medicare

Eva DuGoff, PhD, MPP Ruth Tabak, MPP, MPH Tyler Diduch, MS Viviane Garth, BA
In a review of literature published since the Affordable Care Act’s passage, more than half of analyses find that Medicare Advantage outperforms traditional Medicare on quality, health, and cost outcomes.
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April 21st 2021

Medicare APMs at a Crossroads

François de Brantes, MS, MBA Valinda Rutledge, MBA Kevin Bozic, MD, MBA
To be sustainable and successful, Medicare alternative payment models (APMs) have to attract and retain high and low performers. That requires a different approach to pricing and evaluation.
CMMI Remains Dedicated to Value-Based Care Despite Pause to Some Models, Fowler Says
April 20th 2021

CMMI Remains Dedicated to Value-Based Care Despite Pause to Some Models, Fowler Says

Laura Joszt, MA
During her opening plenary at the NAACOS Spring 2021 Conference, Liz Fowler, PhD, JD, deputy administrator and director of the Center of Medicare and Medicaid Innovation, highlighted how the center is taking a pause to reassess its models and what is coming next.
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April 15th 2021

Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional Medicare

Adrianne W. Casebeer, PhD Richard Schwartz, BS Harmit Patel, MS Ariel Caplan, BS Rituparna Bhattacharya, PhD Charron Long, PharmD Anup Sharma, MD Tich Changamire, MD Claudia Uribe, MD Chuck Stemple, DO Kali Thomas, PhD Mark Newsom, MS Phil Painter, MD William Shrank, MD Courtney R. Brown, PharmD
Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
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April 1st 2021

Comparing Apples With Oranges: Administrative Expenses and Finances in Medicare Systems

Dalit Baranoff, PhD Etti G. Baranoff, PhD Thomas W. Sager, PhD Bo Shi, PhD
In the debate of administrative expenses for public and private Medicare, we show incompatibility and extend the analysis to income, benefits, and loss ratio comparisons.
Contributor: Postdischarge Medication Reconciliation Is the Key to Reducing Hospital Readmissions
March 30th 2021

Contributor: Postdischarge Medication Reconciliation Is the Key to Reducing Hospital Readmissions

Jason Z. Rose, MHSA
Medicare Advantage plans have a clear opportunity to improve quality by delivering more comprehensive, timely medication reconciliation services to recently discharged members.
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