Medicare

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.

Quality evidence is needed to support a new Medicare Part D medication therapy management (MTM) program performance measure, prompting a scoping review on MTM services and associated outcomes.

Experts unpacked MFN drug pricing, expired ACA subsidies, and IRA fallout for community oncology in a recent webinar.

The Inflation Reduction Act introduced Medicare drug price negotiations to reduce treatment costs, enhance access, and potentially reshape prescribing patterns in oncology and hematology.

Nearly 3 million MA enrollees may lose plan coverage in 2026 as payment reforms drive market exits, hitting rural areas hardest and reshaping competition, explains Mark Meiselbach, PhD.

ACOs entering MSSP with higher spending were consistently more likely to earn bonuses—a gap that persisted after a 2017 benchmarking policy change.

Mark Meiselbach, PhD, at Johns Hopkins, explains Medicare Advantage market corrections, Star Rating System pressures, and rural plan exits.

MA grocery card use was associated with modest increases in wellness, primary care, and specialist visits among dual-eligible beneficiaries, says Jennifer L. Kowalski, MS.

Kristie Spencer, vice president of provider partnerships at Elevance Health, on how value-based care is improving quality metrics and addressing social determinants of health.

Reform priorities aim to reshape PBM oversight, delink compensation from drug prices, boost transparency, and protect pharmacy access.

Medicare Advantage beneficiaries face forced disenrollment in 2026 as plan exits drive coverage termination, pushing millions toward traditional Medicare and Part D’s $2100 cap.

Penetration of Medicare Shared Savings Program accountable care organizations and Medicare Advantage was not associated with substantive changes in health care use among commercial enrollees.

The editor in chief of Evidence-Based Oncology lauds Congress' authorization of a path for Medicare coverage for multicancer early detection.

Medicare Advantage enrollment has increased in the US and Puerto Rico, with a dramatic growth among Puerto Rico beneficiaries with end-stage renal disease.

The postpandemic reinstatement of Medicare’s 3-day rule lengthened hospital stays without affecting SNF use, spending, or short-term outcomes, raising questions about its value.

The authors call for policy reforms that could strengthen patient-provider relationships, support care innovation, and improve quality for Medicare beneficiaries.

Beneficiaries in ACOs receive significantly higher rates of primary and preventive services, signaling value-based care’s impact on quality and chronic disease management.

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

The upcoming price negotiations are the third cycle since the Inflation Reduction Act was passed in 2022.

The decline in primary care providers threatens Medicare FFS patients' access to new visits, highlighting urgent needs for policy reform and workforce solutions.

The ACCESS Model signals a shift toward outcome-aligned payments and a necessary reframing of what “value” actually means.

The most-viewed content focused on the “One Big Beautiful Bill,” the Most Favored Nation drug policy, and other changes under the Trump administration.