Payers

MedPAC to Congress: Change MA Benchmarks, Slow Down on APMs

June 18th 2021, 12:15pm

Article

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.

Supreme Court Tosses Challenge to ACA for Lack of Standing

June 17th 2021, 4:23pm

Article

In a 7 to 2 decision, the Supreme Court ruled Thursday that the Affordable Care Act (ACA) will stand, as plaintiffs seeking to declare the law unconstitutional did not have standing.

Commercial and Medicare Advantage Payment for Anesthesiology Services

June 16th 2021, 1:00pm

Article

Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.

Pandemic Factors Driving Predictions for 2022 Medical Cost Trends

June 15th 2021, 10:00pm

Podcast

On this episode of Managed Care Cast, we speak with the author of the annual PwC Behind the Numbers report, which looks ahead at medical cost trends in the United States.

Association of Co-pay Elimination With Medication Adherence and Total Cost

June 15th 2021, 1:00pm

Article

This study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.

Association Between Hospital-Insurer Contract Structure and Hospital Performance

June 14th 2021, 1:00pm

Article

Hospital performance measures, such as prices and costs, are associated with hospital-insurer contract types.

What We’re Reading: Donating 500 Million Pfizer Doses; Resignation Over Alzheimer Drug; Nevada’s Public Option

June 10th 2021, 2:05pm

Article

United States to buy and donate 500 million COVID-19 vaccine doses to the world; an FDA advisor resigns over a controversial Alzheimer drug approval; Nevada becomes the second state to offer state-managed health insurance plans.

Who’s Driving the Growth of Medicare Advantage Plans?

June 9th 2021, 10:30am

Podcast

In this episode of Managed Care Cast, we speak with a coauthor of an article in June’s Health Affairs examining the racial and ethnic composition of beneficiaries in Medicare Advantage plans and the potential implications as the program continues to grow.

Contributor: Telehealth Utilization Continues to Fall Nationally From February to March 2021

June 8th 2021, 5:51pm

Article

Community Practices Highlight Advances in ASCO Abstracts

June 6th 2021, 12:15pm

Article

Biomarker testing and remote patient monitoring are just 2 areas of research presented during the annual meeting of the American Society of Clinical Oncology (ASCO).