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.
How Biogen’s Aduhelm Approval Marks a Precipitous Turning Point for the FDAJuly 14th 2021
A string of controversies surrounding the approval of Biogen's Alzheimer disease drug aducanumab (Aduhelm) has not only called into question the independent nature of the FDA, but puts both providers and patients in a challenging position when it comes to deciding whether or not to prescribe or take the treatment.
Care for Food-Insecure Enrollees in Medicare Advantage vs Traditional MedicareJuly 12th 2021
Medicare Advantage plans may deliver care more efficiently to food-insecure beneficiaries than traditional Medicare, but they are not better at reducing food insecurity.
MedPAC to Congress: Change MA Benchmarks, Slow Down on APMsJune 18th 2021
The Medicare Payment Advisory Commission (MedPAC) suggested several changes to Medicare Advantage (MA) plan benchmark calculations, with the intent to generate yield savings for Medicare, and urged CMS to streamline alternative payment model (APMs) where it can.
Softer Alignment of Medicare ACOs May Still Lead to Higher Prices for Office VisitsJune 7th 2021
The researchers created a model that simulated what would happen when health systems and providers began working together in Medicare accountable care organizations (ACOs) in arrangements that did not extend to outright mergers or acquisitions.
Dr Davey Daniel on Lower Cost of Care Seen in Clinical Trials for OCM EnrolleesJune 4th 2021
Davey Daniel, MD, hematology/medical oncology specialist, Tennessee Oncology, discusses findings of an abstract presented at ASCO 2021 showing a lower total cost of care paid by Medicare for episodes of care for patients in the Oncology Care Model (OCM) enrolled in clinical trials vs those receiving routine care.
Variability of COPD Inhaler Coverage in Medicare Part DMay 11th 2021
Although most Medicare Part D plans cover guideline-recommended outpatient chronic obstructive pulmonary disease (COPD) inhalers, the utilization controls applied to these therapies vary by plan type.
Quality, Health, and Spending in Medicare Advantage and Traditional MedicareMay 6th 2021
In a review of literature published since the Affordable Care Act’s passage, more than half of analyses find that Medicare Advantage outperforms traditional Medicare on quality, health, and cost outcomes.
To be sustainable and successful, Medicare alternative payment models (APMs) have to attract and retain high and low performers. That requires a different approach to pricing and evaluation.
CMMI Remains Dedicated to Value-Based Care Despite Pause to Some Models, Fowler SaysApril 20th 2021
During her opening plenary at the NAACOS Spring 2021 Conference, Liz Fowler, PhD, JD, deputy administrator and director of the Center of Medicare and Medicaid Innovation, highlighted how the center is taking a pause to reassess its models and what is coming next.
Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional Medicare
Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
Comparing Apples With Oranges: Administrative Expenses and Finances in Medicare SystemsApril 1st 2021
In the debate of administrative expenses for public and private Medicare, we show incompatibility and extend the analysis to income, benefits, and loss ratio comparisons.
Contributor: Postdischarge Medication Reconciliation Is the Key to Reducing Hospital ReadmissionsMarch 30th 2021
Medicare Advantage plans have a clear opportunity to improve quality by delivering more comprehensive, timely medication reconciliation services to recently discharged members.