High-Risk Care Management Impact on Medicaid ACO Utilization and Spending
In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.
Premium Tax Credits in the American Rescue Plan and Off-Marketplace Enrollees
We estimate that the median 2021 premium tax credit for off-marketplace enrollees in California would be $311 if they switched to marketplace plans, with wide variation by age and plan size.
The Introduction of Generic Risperidone in Medicare Part D
This study examines the plan characteristics associated with generic risperidone use and spending and adherence outcomes associated with use among Medicare Advantage Part D beneficiaries.
The Structure of Risk Adjustment for Private Plans in Medicare
Health plan accounting data are used to test how well the CMSHCC risk adjustment system tracks relative costs of treating various diagnoses: not very well.
Medicare Part D Coverage Gap and Diabetes Beneficiaries
When diabetic patients in 2 Medicare Advantage Part D plans reached the 2006 coverage gap, overall drug costs dropped as out-of-pocket costs increased.