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Medicare Advantage Costs Taxpayers 22% More Per Enrollee. Here’s How Payment Reform Could Help Close The Gap.
The overpayment of plans, amounting to $83 billion per year, is unsustainable. The Medicare Advantage payment system needs a broad reform that aligns insurers’ incentives with the needs of beneficiaries and taxpayers.
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How Specialized Are Special Needs Plans? Evidence from Provider Networks
Although envisioned as a way to coordinate benefits between Medicare and Medicaid and serve the specific needs of the dually eligible population, only 46 percent of D-SNP plans feature distinct provider networks from standard MA plans offered by the same insurer.
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Medicare Part D Beneficiaries’ Self-reported Barriers to Switching Plans and Making Plan Comparisons at AllÂ
Over half of Medicare beneficiaries in stand-alone Part D plans kept their coverage without comparing plans during the last enrollment period, and many reported not knowing how to switch plans.
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Most Medicare Beneficiaries Do Not Compare Prescription Drug Plans – And May Be Sticking with Bad Plans
Over half of Medicare beneficiaries in stand-alone Part D plans kept their coverage without comparing plans during the last enrollment period, and many reported not knowing how to switch plans.
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The nation’s growing debt threatens Medicare and Medicaid, which have helped countless Americans and reduced poverty. Schaeffer Center researchers work with legislators on a bipartisan basis to bolster these vital systems, making them more efficient and effective.
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Recent Cohorts Aging into Medicare Use More Counseling and Psychotherapy Than Past Cohorts
More recent cohorts aging into Medicare seek significantly more counseling and psychotherapy than prior cohorts, suggesting that plans must prepare to accommodate the needs of new Medicare entrants.
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Out-of-Pocket Costs Are Substantially Lower in Medicare Advantage Than Traditional Medicare
Expected monthly out-of-pocket costs for a typical enrollee were about 18-24% lower in Medicare Advantage in recent years, which likely helped fuel the program’s enrollment surge.
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Expected Out-Of-Pocket Costs: Comparing Medicare Advantage With Fee-For-Service Medicare
Expected monthly out-of-pocket costs for a typical enrollee were about 18-24% lower in Medicare Advantage in recent years, which likely helped fuel the program’s enrollment surge.
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The Inflation Reduction Act and Patient Costs for Drugs to Treat Heart Failure
Although previous legislation technically closed the Part D coverage gap, patients still faced mid-year out-of-pocket increases. The Inflation Reduction Act’s standard benefit design eliminates the coverage gap in 2025.
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Opinion: I’m a Doctor in East L.A. and Beverly Hills. I Want to Treat Obesity the Same Way in Both Places
Use of newer anti-obesity medications in any part of town can provide true benefit even if lifestyle changes are harder to implement.
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The CBO Report on Medicare and Anti-Obesity Medications Should Not Be the Final Word
The highly anticipated report contains clues on how Congress may come to a different view on medications like Wegovy and Zepbound.
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