Medicare

During a White House briefing, Mehmet Oz, MD, discussed the expansion of Trump Rx and crackdowns on duplicate ACA enrollment and fraudulent hospice programs.

The problem is not that price transparency itself has failed, but rather that policy makers have focused their efforts on the wrong place.

The authors describe Medicare Advantage plans that screen for and provide supplemental benefits addressing social needs and explore how these benefits meet communities’ social needs.

Medicare FFS beneficiaries with metastatic cancer received broad genomic profiling more often than MA patients.

Beneficiaries in socially vulnerable communities received higher-quality, more-efficient care under value-based care (at-risk Medicare Advantage) compared with those in fee-for-service Medicare payment arrangements.

Claims data linked eviction protection rollbacks to higher psychotropic prescription and SMI visits, revealing housing security’s mental health toll.

This study evaluated differences in racial and ethnic disparities in surgical outcomes between Medicare Advantage and traditional Medicare beneficiaries, finding consistent but nonuniform smaller disparities within Medicare Advantage.

Food insecurity identification modeling for Medicare can establish a reliable method of prioritizing members at risk of food insecurity for identification and program enrollment.

Evidence suggests that adoption of oncology biosimilars in Medicare value-based payment models has produced substantial cost savings and improved provider financial performance.

OCM showed no increased likelihood of starting systemic therapy in patients with newly diagnosed cancers, despite gains in poor-prognosis cases.

A lengthy Ways and Means Committee hearing revealed extensive Medicare system exploitation and ignited partisan debates on fixing it.

The 2018 permanent authorization of dual-eligible special needs plans marked a significant long-term commitment by policy makers and coincided with substantial growth in plan offerings and enrollment.

KFF Health Tracking Poll finds prior authorization tops patient hassles; Drew Altman, PhD, warns complexity delays care, hitting chronic patients hardest.

Two posters presented at AMCP 2026 found low dry eye disease (DED) treatment uptake and frequent discontinuation among Medicare patients, whereas comorbid DED did not affect glaucoma adherence.

Major health plans cut millions of preapproval hurdles, add 90-day continuity protections, and push real-time e-authorization to speed care access.

The cap cut quarterly spending by the hundreds and lowered A1c levels but failed to expand the pool of insulin users.

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same individuals prior to age 65 years.

Experts at the 2026 AAD Annual Meeting urged dermatologists to engage in advocacy to protect practices and patient access amid growing challenges.

New studies show 2024 IRA Medicare drug caps and expanded subsidies cut cost-related nonadherence, especially for those with chronic disease.

Medicare Advantage enrollees with advanced cancer had higher hospice use than those with traditional Medicare, highlighting disparities in end-of-life care.

Insulin affordability improved for Medicare Part D beneficiaries between 2019 and 2023, with more paying $35 or less for a 30-day supply.

This study assessed the impact of hyperpolypharmacy on hospital readmission risk in 2 Medicare populations and identified effects of postdischarge ambulatory care.

Accountable care experts say the future of value in Medicare will rely on scaling up innovation, emphasizing downstream prevention, and staying alert to waste.

As Medicare Advantage grows, first-time enrollees demonstrate increasing demographic and clinical diversity, indicating that benefits should be designed to reflect the population’s changing composition.

This study of 26,805 cardiologists shows that industry payments (averaging $3958) are linked to increased Medicare costs, with each $10,000 in payment associated with $14.1 higher beneficiary spending.