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.

New Enhancing Oncology Model Builds on Knowledge From the OCM

August 15th 2022, 7:12pm

Article

OCM Successor Puts Focus on Equity in Cancer Care—With Fewer Dollars for Services

August 15th 2022, 6:50pm

Article

Contributor: How Medication Risk Scores Improve Health for Medicare Beneficiaries

July 27th 2022, 12:45pm

Article

Medication risk scores analyze an individual’s medication regimen to look for the potential for simultaneous, multi-drug interactions, which can cause adverse drug events and other medication-related harms.

Contributor: The Need to Go Beyond Medication Adherence in the Medicare Population

July 18th 2022, 5:33pm

Article

Medication adherence is not the only area to focus on for older adults who have Medicare coverage. Optimizing treatment and medication access are also important.

Geographic Variation in Medicare Home Health Expenditures

July 13th 2022, 1:00pm

Article

This study attempts to identify the sources of the significant 2.5-fold variation found in home health expenditures, a possible indicator of inefficiency and waste.

Medicare Advantage Coverage Restrictions for the Costliest Physician-Administered Drugs

July 12th 2022, 1:00pm

Article

Four large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.

Contributor: Technology, Supplemental Services in MA Can Help Improve Participant Health

July 10th 2022, 10:24am

Article

Social determinants of health present many health-related challenges for Medicare Advantage (MA) plan members, something these plans are looking to overcome by diversifying their service offerings.

Treatment Simplification and Personalized Interventions May Reduce Medication Nonadherence

July 4th 2022, 1:58pm

Article

Simplified treatments and patient-specific and systemic interventions can reduce nonadherence in patients.

CMS Announces OCM Successor, but Gap Year Remains for Oncology Practices

June 27th 2022, 8:59pm

Article

Today, CMS unveiled its plan for a successor to the Oncology Care Model (OCM), its ambitious foray into value-based care delivery that has been credited with changing the landscape for patients with cancer, even if it received mixed reviews on achieving savings in its early years.

Dr Debra Patt Addresses Medicare’s Successful Reimbursement of Telemedicine

June 26th 2022, 2:41pm

Video

Debra Patt, MD, PhD, MBA, executive vice president of Texas Oncology, discusses the path of telemedicine reimbursement during the pandemic and possible ways it will change after the pandemic.