May 6, 2024

Medicare Part A Trust Fund Has A Bit More Life

The Medicare Part A Insurance Trust Fund will be solvent for longer than previously projected says the annual Medicare Trustees report. While there are “significant financing issues,” the program will be able to pay all scheduled benefits until 2036, five years longer than the last report. No one can take policy credit (even though the Biden administration will try to do so) for meaningfully adding years to Medicare’s life.  It is all related to technical issues and occurrences. The truth is no party has a coherent policy to stabilize Medicare or entitlements for that matter. Benefit cuts or tax increases will be big if nothing is done.

Additional articles: https://www.beckershospitalreview.com/finance/medicares-financial-picture-brightens-slightly.html and https://thehill.com/policy/healthcare/4647137-medicare-fund-economy-solvent-yellen/

#medicare #entitlements #healthcare


States Jumping In To Scrutinize Private Equity Investments

Where the feds have failed, states are increasingly jumping in to scrutinize private equity firm investments in health care. From 2019 to 2023, almost two-third of transactions had private equity involvement. The article discusses state laws and oversight, including mandatory reporting.  This comes as Steward Health Care, which has 30 hospitals in 8 states and has private equity backing, files for bankruptcy.

Additional articles: https://www.healthcaredive.com/news/steward-health-care-files-chapter-11-bankruptcy/714050/ and https://www.fiercehealthcare.com/hospitals/struggling-steward-health-care-files-bankruptcy and https://www.modernhealthcare.com/providers/steward-health-care-bankruptcy

(Some articles may require a subscription.)

#privateequityfirms #consolidations #mergers #manda #hospitals #antitrust


Medicaid Directors Want Action On 1115 Waiver Backlog

Medicaid Directors are asking Congress to supply more staff to the Centers for Medicare and Medicaid Services (CMS) to speed along the backlog of 1115 research and demonstration waivers filed by states.

(Article may require a subscription.)



Preventive Services Task Force Could Clear GLP-1s In Future

The United States Preventive Services Task Force (USPSTF) is developing a plan that will consider whether to grade preventive medications for chronic weight management as mandatory preventive drugs.  This could lead to them being mandated to be covered at zero cost to enrollees in certain insurance plans. This is an amazing development and could literally bust the healthcare system.  Many organizations are finding that coverage of such drugs right now just do not save.  This includes the Congressional Budget Office (CBO). But the USPSTF does not consider costs in the short or long term. There is a 50-50 shot that a federal court could declare the task force’s declarations null and void in terms of forcing zero-cost preventive services, including drugs.

(Article may require a subscription.)

#prevention #healthcare


Becker’s Assembles Q1 2024 Medical Loss Ratios

Becker’s has assembled the medical loss ratios for leading insurers for Q1 2024.  By and large, plans with strong commercial portfolios did better than those with major government programs.  In the case of CVS, they saw a huge surge in government health plan lives.

#mlrs #medicareadvantage #medicaid #healthplans


MA Plans To Cut Benefits In 2025

It is clear based on Q1 2024 investor calls that the major Medicare Advantage (MA) health plans will be cutting benefits in 2025 due to low rate hikes, poor Star ratings, and increasing costs.



Mississippi Fails To Pass Medicaid Expansion

What was a promising move, ended in failure as the Mississippi legislature failed to pass a Medicaid expansion.  The two chambers were split on whether to include work rules in the expansion. The Senate squashed a proposal for a referendum to decide if work requirements should be included. The Senate refused to accept legislation without work requirements.

#ms #medicaid #aca #obamacare #coverage


Dual Eligible Medicare Enrollment Should Change

Interesting Health Affairs Forefront Blog on the need to change how dual eligibles are enrolled in Medicare Advantage (MA).  Authors make a convincing case that the special needs of duals need to be taken into consideration, especially as integration between the two programs take hold.

(Article may require a subscription.)

#dualeligibles #medicareadvantage #medicaid


Why Did Health Affairs Publish PhRMA’s Propaganda?

I am a bit perplexed by why the Health Affairs Forefront Blog published the Pharmaceutical Research and Manufacturers of America’s (PhRMA) Medicare drug price negotiation propaganda. As a Republican, I don’t view the Inflation Reduction Act’s provisions on Medicare as particularly out of the mainstream. I don’t know that it will compromise the health and welfare of America as the authors’ speculate. What is missing from the article is the fact that brand drug makers fully take advantage of the American market even as they offer steep discounts in other developed countries.  Why haven’t they come forward with a proposal that supposedly mirrors the better systems in other countries?  Because they don’t want to.  They are hanging their hats on winning in court, which looks doubtful.

(Article may require a subscription.)

#ira #medicare #drugpricing #branddrugmakers


— Marc S. Ryan

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