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Top 5 Most-Read Medicare Articles of 2021
This year’s most-read articles on Medicare covered topics including accountable care organizations, value-based payment, and star ratings.
The top 5 most-read Medicare stories of 2021 on AJMC.com focused on star rating increases, value-based payment ideas, and the risks of polypharmacy. They also explored the price impacts of accountable care organizations (ACOs) and the ramifications of the FDA’s approval of an Alzheimer disease drug.
Here are the top 5 most-read Medicare articles of 2021.
5. Softer Alignment of Medicare ACOs May Still Lead to Higher Prices for Office Visits
What happens to health care prices when practices align in ACOs instead of outright mergers or acquisitions? This article from June covered the findings of a study that investigated this question and found that practices joining health system–led ACOs saw an average of 4% higher prices. The study authors cautioned that these arrangements may warrant closer monitoring.
4. Most MA Plans in Annual CMS Report See Star Ratings Increase
The number of Medicare Advantage (MA) plans receiving a 5-star rating from CMS increased to 87 for the 2022 performance year, according to this October article covering a fact sheet released by CMS. Of note, 11 quality measures saw increases since the year prior, but most measures declined, owing to the effects of the COVID-19 pandemic. CMS also said that plans offered by nonprofit organizations tend to earn higher ratings than those from for-profit companies.
3. Biden Administration Drug Plan Includes Value-Based Payment Ideas for Medicare
This article covered the plan to reduce prescription drug prices that was released by the Biden administration in September. The plan includes the use of models to test value-based payments in Medicare Part B, and some other tenets include promotion of biosimilars and price negotiation with manufacturers. In particular, it suggested the use of shared savings models in which Part B savings from using biosimilars or generics would be shared between the government and the prescribing providers.
2. How Biogen’s Aduhelm Approval Marks a Precipitous Turning Point for the FDA
This article from July took a deep dive into the controversies surrounding the FDA’s approval of Biogen’s aducanumab (Aduhelm) for Alzheimer disease in June. The drug’s route through an accelerated approval process and contradictory evidence of efficacy could jeopardize the public’s trust in the FDA at a crucial time, and some clinicians interviewed by AJMC.com said they would be hesitant to prescribe it. The article noted that CMS has begun an analysis to determine whether Medicare will have a national coverage policy for aducanumab, which is projected to cost $56,000 for 1 year of treatment.
1. Polypharmacy Linked to Higher Risk of Hospital Readmission
Polypharmacy, or taking 5 or more prescriptions per day, was associated with a higher risk of 30-day hospital readmission, according to study findings that we covered in July. In examining the risk of readmission, investigators found that polypharmacy had an odds ratio (OR) of 1.043 for each additional drug prescribed, which was higher than the OR for length of stay (1.014 per additional stay). Certain drugs, such as antiemetics and antinauseants, had a stronger link with readmission than others. The study authors noted that the drivers of hospital readmissions should be further investigated in predictive research.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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The Federal Trade Commission's (FTC's) vote to ban most employers from issuing and enforcing noncompete clauses could have varying impacts on the health care workforce; federal regulators vastly under-enforced antitrust laws in the hospital sector during the last 2 decades, resulting in increased health costs; the FDA recently found genetic evidence of the H5N1 bird flu virus in pasteurized commercially purchased milk.
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