MedPAC Largely Pans Hospitals’ Complaint On MA Penetration
Congressional Medicare policy advisor MedPAC panned hospitals’ views that increased penetration of Medicare Advantage (MA) is impacting providers’ financial stability. Empirical analyses conducted by MedPAC staff showed no evidence of a significant association between MA market penetration and all-payer margins of hospitals, skilled nursing facilities (SNFs), and home health agencies. This does not appear to be the case in rural markets, either.
But MedPAC did find some changes in revenues, costs and utilization trends and some of it was in hospitals’ favor. MA enrollees’ average length of stay in fiscal year 2024 was actually 11.2% longer than fee-for-service (FFS) beneficiaries. This was related to those who were destined to be discharged to a post-acute care facility. And overall greater MA penetration was tied to dips in total SNF facility days and small declines in revenues and costs at SNFs and home health.
#medicareadvantage #providers #hospitals
https://www.fiercehealthcare.com/payers/medpac-offers-look-enrollment-hiccups-medicare-beneficiaries
Dems Largely Push Centrists For Midterms
Learning a lesson from 2024, Democrats seem to be pushing and winning the endorsement of the public with centrist candidates. This is especially true in swing districts and purple states, which does not bode well for GOP prospects.
Affordability issues seem to be resonating. Centrist approaches to healthcare policy are also winning out against more radical ideas, such as Medicare for All. One exception is the win of Graham Platner in Maine for the Democratic nomination for Senate.
(Article may require a subscription.)
#2026midterms #healthcare #coverage
Wakely Explains Extrapolation
Wakely Consulting published a good briefer on extrapolation in Medicare Advantage (MA) Risk Adjustment Data Validation. I note that no federal rule stands right now to support its fulsome use, but plans need to be prepared.
#medicareadvantage #riskadjustment #radv
https://www.wakely.com/blog/medicare-advantage-radv-extrapolation-a-practical-guide-for-plans/
KFF Briefs On The Uninsured
Healthcare policy group KFF published a briefer on the profile of the uninsured. Some key facts:
- The total number of people ages 0-64 without health coverage increased by more than 1.3 million to 26.7 million in 2024.
- The uninsured rate for the population under age 65 increased from 9.5% to 9.8%.
- A decline in Medicaid coverage drove the increase in the uninsured rate in 2024.
- 80.1% who are uninsured were in low-income families.
- A disproportionate share of uninsured individuals under age 65 (42%) live in the ten states that have not expanded Medicaid.
High costs drive the uninsured rate and more than half may be eligible for supported coverage.
#uninsured #healthcare #coverage
https://www.kff.org/uninsured/key-facts-about-the-uninsured-population/
— Marc S. Ryan
