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Strong Medicare Advantage Enrollment Growth Continued From February To March

In my January 22, 2024 Healthcare Labyrinth Blog ( https://www.healthcarelabyrinth.com/great-news-for-insurers-and-medicare-beneficiaries-january-2023-to-january-2024-medicare-advantage-growth-rebounds/ ), I told you about the exciting news of Medicare Advantage’s (MA) continued strong growth (from January 2023 to January 2024) as well as a nice recovery from a bit of a sluggish increase from January 2022 to January 2023. As I always do, I publish a follow-up blog in the first few months of each year given continuing growth outside of the main enrollment season from October 15 to December 7. This is because of a somewhat recent change that allows members enrolled in a MA plans to change to a different MA plan or go back to traditional Medicare (and also choose a standalone Part D (PDP) plan. This occurs from January 1 to March 31 of each year. Because of this, MA plans continue to advertise vigorously to attract additional members and there is net new enrollment

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The Trump-Biden Great Entitlement Debate

After promising not to touch Social Security and Medicare throughout his campaign, GOP 2024 candidate and former President Donald Trump seemingly reopened his views on the issue – only to have Biden attack him and then Trump having to clean up after. Here is the back and forth (this could be the only real debate we see from the candidates) : In comments to a journalist on whether he had changed his views on entitlements, Trump declared: “So first of all, there is a lot you can do in terms of entitlements in terms of cutting and in terms of also the theft and the bad management of entitlements, tremendous bad management of entitlements. … There’s tremendous amounts of things and numbers of things you can do. So I don’t necessarily agree with the statement.” It seems reasonably clear that Trump likely was talking about cleaning up administration and fighting

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King Charles’ Cancer Diagnosis Shines A Light On Holes In The U.K.’s Healthcare System – And Ours

In early February, Buckingham Palace announced that King Charles has been diagnosed with cancer. As is often the case for the royals’ personal lives, not a lot is always shared. But the King and his now deceased mother should be congratulated for some of their openness. Like his mother’s announcements when her health was in question, the King’s announcement was meant to encourage everyone to take care and get preventive care performed. At the same time, the King’s announcement has shined a light on some of the problems in the United Kingdom’s healthcare system. As I have covered a few times in my blogs, the U.K. just celebrated its National Health Services’ 75th anniversary of its founding a few years after World War II ended. The U.K. took the socialized medicine approach, where the government funds, directs, runs, and largely provides healthcare services to its citizens. Some other nations in

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Joe Biden Goes On The Offensive With Healthcare Reforms

Looking for any angle to take the focus off his age and the economy overall, President Joe Biden and Democrats are now focusing on healthcare in the presidential election. In my mind, it is a very good strategy. As I have said in previous blogs, my Republican Party has a compassion gap when it comes to healthcare. Republicans have not formulated any real agenda on healthcare reform. Most tend to distance themselves from any talk of reform. More right-wing elements talk actively of repealing the Affordable Care Act (ACA), which has helped in the neighborhood of forty million Americans (not counting those with pre-existing conditions and on their parents’ policies until age 26.) Whatever you think of some of the Democrats’ ideas, the party has actively embraced healthcare reform. Some ideas I clearly hate, such as Medicare for All. But others, like drug price reform and anti-trust activities, make a

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March 5, 2024

Cuban Recommends Radical Change In Drug World To Reduce Costs I am a big fan of Mark Cuban and what he and his Cost Plus Drugs are doing to reform the drug price system.  So when he speaks, I listen.  At a White House round table, Cuban proposed that federal programs cut off all ties to traditional pharmacy benefits managers (PBMs) and embrace full transparency.  He has a direct-to-consumer firm and various transparent PBMs are all in on this idea.   The White House liked the transparency idea but knows it is easier said than done and there are many barriers to unravel what we have now. I note that the transparency model emerging right now works well for generic drugs, but it will be harder and take more time for brand drugs, especially until we get prices lower and solve for the shadowy rebate system. But Cuban’s transparency and

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March 4, 2024

FFY 2024 Spending Package Agreed To By Key Lawmakers A bipartisan spending bill has been agreed to by key lawmakers and will need to be voted on in each House.  The package basically cuts in half the Medicare doc fix cut of 3.4%, pushes back scheduled disproportionate share hospital (DSH) payment cuts, and increases annual funding for community health centers. Accountable Care Organizations’ (ACOs) bonus program was also protected. Absent from the bill are major healthcare reforms. Docs are not very happy with the partial fix and no total overhaul of their rates. Additional articles here: https://www.fiercehealthcare.com/providers/congress-reaches-spending-deal-doc-pay-bump-delayed-dsh-cuts-and-more and https://insidehealthpolicy.com/health-insider/lame-duck-battle-looms-health-wins-skinny-bill-expiring-december and https://insidehealthpolicy.com/daily-news/skinny-health-package-scales-back-doc-fix-adds-chc-funding and https://www.medpagetoday.com/practicemanagement/reimbursement/109008 and https://thehill.com/policy/healthcare/4507164-government-funding-bills-leave-out-phamacy-benefit-manager-industry-changes-as-white-house-mulls-reforms/ (Some articles may require a subscription.) #governmentshutdown #healthcare Link to Article All Drug Makers Submit Counter Offers In Medicare Drug Price Negotiations The White House announced that all ten companies involved in the initial Medicare drug price negotiations have sent in counter proposals to what

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Part 4: My Courageous Daughter Is Having Brain Surgery!

This is one of a number of blogs that will appear on my daughter. I call her Kitty. She is a wonderfully talented, bright, and empathetic individual in her late ‘20s. She and I agreed I would write this series to impart how important health coverage is. Not only is her decision to have surgery courageous, but so is her decision to share her journey through me. The principal reason to share the journey is because we both want to explain what many average Americans go through financially when they have major operations and do not have the best insurance or no insurance at all. My daughter is privileged to come from a well-off family and to have consistent and robust insurance. This will mean that she will pay a tiny amount for a surgery with a sticker price in the hundreds of thousands of dollars. But for uninsured and

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March 1, 2024

Medicare Advantage Will Remain Viable Over The Long Run Good article in Modern Healthcare discussing the fact that, while there will be major bumps in the road, Medicare Advantage (MA) will remain viable and strong.  A great quote from Paul Ginsburg, senior fellow at the University of Southern California Schaeffer Center for Health Policy and Economics. “We’re not talking about any risk to the financial integrity of these companies at all. The Medicare Advantage business is very viable long-term because they’re providing something that more and more Medicare beneficiaries are deciding they want,” Ginsburg said. “Will it be as great for the next few years as it has been? Probably not. It’ll still be very good, though.” This echoes what I said in a January 29, 2024 blog ( https://www.healthcarelabyrinth.com/with-boom-over-will-medicare-advantage-collapse-or-adjust/ ) as well as a February 9 Podcast ( https://www.healthcarelabyrinth.com/9-is-medicare-advantage-exploding-after-its-boom-or-simply-adjusting/ ). As I say, the real victims of terrible policies

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February 29, 2024

Change Healthcare Cyber Attack Fallout Continues The fallout continues over the cyber attack suffered by Change Healthcare.  United Health Group confirmed the attack was a ransomware one and that the BlackCat cyber gang was behind it. Additional article here:https://www.modernhealthcare.com/cybersecurity/change-healthcare-cyberattack-outage-blackcat-alphv-2024 As well, good overviews of cyber security and the overall event and impacts: https://www.modernhealthcare.com/cybersecurity/change-healthcare-outage-cyberattack-data-breaches-2024 and https://kffhealthnews.org/news/article/unitedhealth-change-healthcare-blackcat-hack-cybersecurity/ Meanwhile, a prominent provider group is calling on the federal government to help them regarding the current Change Healthcare cyber attack, but to also strengthen security overall: https://insidehealthpolicy.com/daily-news/mgma-hhs-help-industry-mitigate-massive-ransomware-attack (Some articles may require a subscription.) #cyberattacks #changehealthcare Link to Article Congress Passes Short-Term Funding Bill The House passed a short-term funding bill by a vote of 320-99 vote and the Senate turned around passing it with a 77-13 vote.  It pushes a government shutdown out to March 8 and March 22. Work continues on appropriation bills.  House Speaker Mike Johnson, R-LA, is under attack by his

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Medicare Advantage Enrollment Growth Continued From January To February

In my January 22, 2024 Healthcare Labyrinth Blog ( https://www.healthcarelabyrinth.com/great-news-for-insurers-and-medicare-beneficiaries-january-2023-to-january-2024-medicare-advantage-growth-rebounds/ ), I told you about the exciting news of Medicare Advantage’s (MA) continued strong growth (from January 2023 to January 2024) as well as a nice recovery from a bit of a sluggish increase from January 2022 to January 2023. As I always do, I publish short follow-up blogs in the first few months of each year given continuing growth outside of the main enrollment season of October 15 to December 7. The key takeaways from the January 22, 2024 blog were: So what happened with February enrollment? A change over the past few years now allows all members enrolled in an MA plan to change to a different MA plan or go back to traditional Medicare (and also get a standalone Part D plan) between January 1 and March 31 of each year. Previously, an MA member could only

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