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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.

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Inflation Reduction Act | Image Credit: wladimir1804-stock.adobe.com
Community Oncology Bracing for IRA Impact

May 31st 2025

Community oncology faces significant challenges from the Inflation Reduction Act's (IRA) drug pricing changes, risking financial stability and patient access to care.

Veteran health. | Image Credit: Africa Studio - stock.adobe.com
Strategies to Address Veteran Health Disparities Beyond the Battlefield

May 30th 2025

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Health Policy in Flux: Trump Administration Updates

May 20th 2025

AJMC
Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare

May 9th 2025

AJMC
Evaluating Access to Care for Medicare Beneficiaries Younger Than 65 Years

May 7th 2025

Examining the Benefit of an Innovative Enhanced Medication Therapy Management Model

In this series of articles, the authors present the MedWise Risk Score, an enhanced medication therapy management model, and its impact on medication safety reviews and health care outcomes.

AJMC Supplement Cover for Examining the Benefit of an Innovative Enhanced Medication Therapy Management Model

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February 4th 2022

Value-Based Care Through Postacute Home Health Under CMS PACT Regulations

Patrick Racsa, MS Teresa Rogstad, MPH Brent Stice, MBA Matthew Flagg, MBA Chase Dailey, MBA Yong Li, PhD Brittany Sallee, BS Karen Worley, PhD Anup Sharma, MD David Annand, MD
Among a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
hand holding prescription bottle
February 3rd 2022

Behavioral Therapy Can Help Reduce Polypharmacy in Borderline Personality Disorder, Study Finds

Gianna Melillo
Results of a retrospective study conducted in Spain found that dialectical-behavioral therapy skills training can help mitigate polypharmacy in those with borderline personality disorder.
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February 3rd 2022

What We’re Reading: Boosters Slash COVID-19 Deaths; Generic Restasis Cleared; Medicare Advantage and Health Equity

AJMC Staff
Americans who are boosted are 95 times less likely than unvaccinated people to die of COVID-19, the FDA approved the first generic drug for Restasis to treat dry eye syndrome, and CMS is putting a greater focus on health equity for Medicare Advantage and Part D plans.
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February 2nd 2022

Inability to Access Health Care Due to COVID-19 Among Medicare Beneficiaries

Chanhyun Park, PhD Boon Peng Ng, PhD Kiyoung Kim, PhD
Up to one-fifth of Medicare beneficiaries were unable to access health care due to the COVID-19 pandemic in 2020.
Geoffrey Boyce
January 31st 2022

Array CEO Geoffrey Boyce Discusses AtHome Telebehavioral Health Services

Hayden E. Klein
Geoffrey Boyce, CEO of Array Behavioral Care, discusses Array AtHome’s telebehavioral health services, which are now available to approximately 5 million Humana Medicare Advantage members.
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January 27th 2022

What We’re Reading: Omicron-Specific Vaccine Trials; Health Insurance Enrollment Gains; Public Nursing Home Staffing Data

AJMC Staff
Pfizer and Moderna announced commencement of trials for Omicron-specific booster shots; 14.5 million Americans gained health coverage since November 2021; Medicare’s website for consumers to research nursing home staffing is up and running.
pen and calculator
January 26th 2022

Number of Accountable Care Organizations Joining MSSP in 2022 Grew Slightly, CMS Says

Allison Inserro
In its annual Medicare Shared Savings Program (MSSP) report, CMS said the number of accountable care organizations joining increased, but a trade group said the results should have been better.
pills
January 24th 2022

Study Finds High Polypharmacy Rates Among Those With History of Depression

Gianna Melillo
Results of a study carried out in Iran found those with a recent history of depressive disorders were more likely to suffer from polypharmacy, or taking 5 or more medications concurrently.
What We're Reading
January 21st 2022

What We’re Reading: Unvaccinated Seniors at Higher Risk for Hospitalization, Nursing Homes in Crisis; Alzheimer Groups Protest

AJMC Staff
Unvaccinated older adults are 49 times more likely to be hospitalized after contracting COVID-19; nursing homes are experiencing a major staffing crisis; major Alzheimer groups plan to meet with federal officials and lawmakers to protest the CMS drug proposal.
Pills being weighed
January 19th 2022

Polypharmacy Linked With Rehospitalization, Death Among Patients With HF

Gianna Melillo
An analysis conducted in Japan among patients with acute decompensated heart failure (HF) revealed excessive polypharmacy at hospital discharge is associated with an increased risk of mortality after 1 year.
Jason Z. Rose, MHSA
January 16th 2022

Contributor: Technology-Based Telepharmacy Needed to Engage High-risk Patients, Improve Medication Adherence

Jason Z. Rose, MHSA
Medicare Advantage plans must leverage data-driven insights and omnichannel telepharmacy software to guide meaningful interactions with high-risk members and boost Star Ratings performance.
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January 14th 2022

Medicine Review Reduces Polypharmacy in Older Adults

Allison Inserro
The randomized study consisted of an intervention delivered by general practitioners in the Republic of Ireland.
Graphic illustrating healthcare costs
January 11th 2022

CMS Says It Will Limit Biogen’s AD Drug to Patients in Clinical Trials

Allison Inserro
In a National Coverage Determination decision memo released Tuesday, CMS said it will gather public comment for 30 days about its plan to limit coverage for Alzheimer disease (AD) biologics that target plaque buildup in the brain to patients enrolled in certain clinical trials.
Image of conversation between physician and older patient
January 8th 2022

Increased Patient-Physician Dialogue in EDs May Reduce Polypharmacy in Older Patients

Rose McNulty
A Danish study observed emergency department (ED) health care providers and identified 5 factors that could play into patient involvement in medication discussions, particularly in older patients with polypharmacy.
graphic representing cost of health care
January 7th 2022

CMS Seeks to Pass Part D Price Reductions to Beneficiaries

Allison Inserro
CMS proposed rulemaking Thursday that would pass pharmaceutical price concessions to beneficiaries in Medicare Part D plans and make the medical loss ratio in Medicare Advantage plans more robust.
Most-Read AJAC Papers of 2021
December 27th 2021

Most-Read AJAC Papers of 2021

Laura Joszt, MA
The most-read AJAC papers of 2021 analyze real-world programs to transform health care and provide insight into physician perspectives of health care and insurance.
Top 5 Medicare 2021
December 25th 2021

Top 5 Most-Read Medicare Articles of 2021

Christina Mattina
This year’s most-read articles on Medicare covered topics including accountable care organizations, value-based payment, and star ratings.
A. Mark Fendrick, MD
December 20th 2021

Covering Key Cancer Services Before Deductible Would Help Close Gaps, Fendrick Says

Mary Caffrey
Coverage from the 2021 COA Payer Exchange Summit.
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December 20th 2021

A Rapid-Fire Look at How Pharma, Practices Are Embracing Oncology Reform

Mary Caffrey
Coverage from the 2021 COA Payer Exchange Summit.
Computer Algorithm May Be Able to Detect Potentially Inappropriate Prescribing
December 18th 2021

Computer Algorithm May Be Able to Detect Potentially Inappropriate Prescribing

Jaime Rosenberg
The findings come from an algorithm that was based on 4 criteria-based tools, including 2 widely-used measures designed to ferret out inappropriate medication prescribing in older adults.
Jackson Williams, JD
December 17th 2021

Contributor: Should Insurance Regulation Be Used to Promote Nontraditional Goals?

Jackson Williams, JD
Three policies to revamp insurance consumer protections for health care delivery are explored, with highlighted areas for improvement being maternal health coverage and loosening of network adequacy requirements.
What We're Reading
December 8th 2021

What We’re Reading: Pfizer Efficacy Against Omicron; Congress Plan to Lift Debt Ceiling; COVID-19 Impact on Mental Health Crisis

AJMC Staff
Antibodies produced by vaccinated people may be less successful at fighting against Omicron compared with other variants; Congressional leaders created a plan to lift the debt limit with only Democratic votes in the Senate, staving off Medicare cuts; cases of depression and anxiety among youths both doubled during the pandemic.
syringe and pills
December 4th 2021

High Rates of Polypharmacy-Associated Adverse Events Seen in Those Aging With HIV

Gianna Melillo
People aging with HIV have more drug–drug interactions compared with those without HIV, according to results of an observational study.
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December 2nd 2021

An Analysis of Medicare Accountable Care Organization Expense Reports

Catherine Hersey, MPH J. Michael McWilliams, MD, PhD Betty Fout, PhD Matthew J. Trombley, PhD Lauren Scarpati, PhD
The authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
Melissa Andel, MPP
November 25th 2021

Melissa Andel on Adding Dental, Hearing, Vision Benefits to Medicare

It’s right to acknowledge that dental, hearing, and vision are important for total health care for Medicare beneficiaries, said Melissa Andel, MPP, vice president of health policy at CommonHealth Solutions.
With No Replacement for OCM on Horizon, Oncology Practices Ask: What Now?
November 22nd 2021

With No Replacement for OCM on Horizon, Oncology Practices Ask: What Now?

Gianna Melillo
The announcement of a "strategic refresh" for payment models under the Center for Medicare and Medicaid Innovation offered no details on what practices should expect when the Oncology Care Model (OCM) expires in 2022.
clipart images of an apple, pill bottle, healthcare forms, doctors, hand holding a heart, piggy bank with a calculator, and a stack of money
November 20th 2021

US Oncology Network, Tennessee Oncology Tout Medicare OCM Savings

Skylar Jeremias
A report from the Centers for Medicare and Medicaid Innovation confirmed that practices within the US Oncology Network and Tennessee Oncology participating in the Oncology Care Model (OCM) program have contributed significant savings to the agency.
With Diversification Advisory Council, SCAN Group Plans for Growth in Care for Older Adults
November 17th 2021

With Diversification Advisory Council, SCAN Group Plans for Growth in Care for Older Adults

Mary Caffrey
To guide its growth and its forays into home-based care, SCAN Group recently announced a Diversification Advisory Council, a group of 6 leaders from inside and outside health care with expertise in health care technology, reimbursement, and consumer engagement.
What we're reading stock photo.
November 15th 2021

What We're Reading: Vaccine Mandate Hold Extended; Medicare Premiums Spike; Booster Eligibility Expands

AJMC Staff
Appeals court affirms decision to place a hold on the Biden administration's COVID-19 vaccine mandate for large employers; rising Medicare premiums linked with controversial Alzheimer drug; 3 states expand COVID-19 booster shot eligibility to all adults.
Jason Z. Rose, MHSA
November 15th 2021

Contributor: Medicare Advantage Plans Can’t Get Complacent About Artificially Inflated 2022 Star Ratings Results

Jason Z. Rose, MHSA
COVID-19 prompted CMS to make major adjustments to the Medicare Advantage (MA) Star Ratings System, resulting in better-than-average performance for nearly all plans. However, these changes were temporary, and MA plans will have to reset their strategies for 2023 and beyond.
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