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Current Medicare News and Events, Medicare News Articles.
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Safety-net clinicians' caseloads received reduced merit-based incentive payment scores
A team of researchers led by Kenton Johnston, Ph.D., conducted a study to investigate how outpatient clinicians that treated disproportionately high caseloads of socially at-risk Medicare patients (safety-net clinicians) performed under Medicare's new mandatory Merit-Based Incentive Payment System (MIPS). (2020-09-10)

COPD program decreases 30-day hospital readmission, may increase mortality
The 30-day readmission rate for patients with chronic obstructive pulmonary disease has decreased but the mortality rate has increased. Hospitals, in seeking to avoid financial penalties by reducing readmissions, may inadvertently affect minority and disadvantaged patients. (2020-09-10)

Generic cholesterol drugs save medicare billions of dollars, study finds
The switch from brand name to generic cholesterol medications that occurred between 2014 and 2018 has saved Medicare billions of dollars, even as the number of people on cholesterol-lowering drugs has increased, UT Southwestern scientists have calculated. Their data, published in the journal JAMA Cardiology, suggest that policymakers and clinicians could help cut Medicare costs even further by switching more patients to generic drugs. (2020-09-09)

Health system clinicians perform better under medicare value-based reimbursement
A team of researchers led by Kenton Johnston, Ph.D. of Saint Louis University's College for Public Health and Social Justice conducted a study investigating the association between health system affiliations of clinicians and their performance scores and payments under Medicare value-based reimbursement. (2020-09-08)

Half of Medicare patients do not receive recommended health care after hospitalization
A study published today by the JAMA Network Open shows that in the period from October 2015 to September 2016 before the Affordable Care Act, a substantial portion of Medicare patients referred to home health care after hospitalization did not receive that care. (2020-09-02)

New database shows more than 20% of nursing homes still report staff, PPE shortages
More than 20% of US nursing homes continue to report severe shortages of staff and PPE, according to one of the first studies based on a new federal database of responses from more than 15,000 facilities. (2020-08-20)

Food-based approach to lowering cholesterol provides significant healthcare cost savings
A new study is the first to show a food-based approach using clinically-proven diet interventions to lower cholesterol levels, such as Step One Foods®, provides significant healthcare cost savings. (2020-08-13)

Quality of care at rural hospitals may not differ as much as reported, study suggests
A Brown University School of Public Health research team found that differences in diagnosis coding practices has resulted in artificially inflated mortality rate comparisons to other hospitals. (2020-08-10)

Initiative to promote a culture of mobility in hospitals yields encouraging results
A paper published today in the Journal of the American Geriatrics Society reported results of an initiative designed to enhance implementation of hospital mobility programs aimed at improving quality of care and outcomes for older patients. (2020-08-05)

Medicare Part D favors generic prescription drugs over branded counterparts, study finds
Published this week in Health Affairs, the study led by Stacie Dusetzina, PhD, Ingram Associate Professor of Cancer Research and associate professor of Health Policy, compared Medicare Part D coverage of more than 1,360 pairs of generic and brand-name drugs. The analysis found 0.9% of plans covered only the brand name drug in 2019, compared to about 84% of plans covering only the generic drug. Roughly 15% of plans covered both the generic and brand-name version. (2020-08-05)

Will telehealth services become the norm following COVID-19 pandemic?
In JAMA Oncology, UNC Lineberger Comprehensive Cancer Center's Trevor Royce, MD, MS, MPH, and his coauthors address whether the routine use of telehealth for patients with cancer could have long-lasting and unforeseen effects on the provision and quality of care. (2020-07-16)

Machine learning accurately predicts who's who in the health care workforce
Until recently, economists, policy makers and workforce experts have relied on outdated and inaccurate snapshots of the US physician workforce, making it especially difficult to predict the need and availability of health care services across the country. In this study, Wingrove et al examine how machine learning algorithms may allow for more real-time, accurate descriptions of the medical workforce. (2020-07-14)

Participants in CPC+ are diverse but not representative of all primary care practices
This study analyzes patterns of participation in the Comprehensive Primary Care Plus initiative which is the largest voluntary primary care payment and delivery reform model tested to date. (2020-07-14)

Study finds weight loss surgery cost disparity
A new study from the University of Georgia finds that users of public insurance are paying more for bariatric weight loss surgery compared to private insurance patients. (2020-07-13)

Study finds cancer mortality rate disparity based on hospital ratings
A new paper in the JNCI Cancer Spectrum, published by Oxford University Press, finds that the mortality rates for complex cancer procedures differ greatly between one-star hospitals (10.4%) and five-star hospitals (6.4%). (2020-07-13)

Medicare's race, ethnic data often undercounts minority populations, study finds
The information critical to a nationwide priority of reducing health care disparities among minorities is incomplete and inaccurate, according to a new Rutgers study. (2020-07-07)

JNCCN study explores if insurance is keeping pace with trends in targeted cancer therapy
New research from the University of California, San Francisco (USCF) and City of Hope in the July 2020 issue of JNCCN--Journal of the National Comprehensive Cancer Network examines coverage trends for circulating tumor DNA testing, also known as gene sequencing of ctDNA or 'liquid biopsies.' The researchers found coverage rate rose from 0% to 38% in three years. The policies also increased in scope from 2017-2019, going from one cancer type to 12. (2020-07-07)

18.2 million at increased risk of severe COVID-19 uninsured or underinsured: Harvard study
Harvard researchers found that 18.2 million Americans who are at increased risk of severe COVID-19 due to age and underlying health conditions were also either uninsured or underinsured. Blacks, Native Americans, lower-income, and rural Americans, or those living in states that had not expanded Medicaid were doubly disadvantaged: they were both more likely to be at high risk of severe COVID-19 and to lack adequate coverage. (2020-06-10)

People with Type 1 diabetes spend $2,500 a year in health care costs
Adults and children with type 1 diabetes will spend an average of $2,500 a year out-of-pocket for health care -- but insulin isn't always the biggest expense -- new research suggests. (2020-06-01)

Report looks to improve quality measures for medical care of homebound older adults
There are an estimated 2 million older adults who are homebound or unable to leave their homes due to multiple chronic conditions and functional impairment. Home-based primary care provides access to care for these patients and has been shown to save costs for the Medicare program. (2020-05-22)

Federal program leads to intensified treatment for high-risk heart patients
A program that offers financial incentives to health care providers to measure and reduce heart attack and stroke risk among Medicare patients resulted in increased preventive medications prescribed to patients in high-risk and medium-risk categories. The Million Hearts® Cardiovascular Disease Risk Reduction Model provides financial incentives to health care providers to reduce heart and stroke risk among high-risk Medicare beneficiaries. (2020-05-15)

Answers to these questions can help #Decision2020 build momentum for Americans as we age
With primary and general elections on the horizon across the US, the American Geriatrics Society (AGS) today released a series of high-priority questions for candidates. The AGS candidate question guide is aimed at helping Americans keep all political leaders -- including and perhaps especially those running for president -- committed to a clear, articulated vision how they will support us all as Americans age. (2020-05-14)

Illuminating the impact of COVID-19 on hospitals and health systems
In the third week of March 2020, as the COVID-19 pandemic escalated, large hospitals in the Northeast experienced a 26 percent decline in average per-facility revenues based on estimated in-network amounts as compared to the same period in 2019. Nationally, the decrease in revenue for large hospitals was 16 percent. These are among the findings of FAIR Health's second COVID-19 study. (2020-05-12)

Fatty liver disease is underdiagnosed in the US
According to an analysis published in Alimentary Pharmacology & Therapeutics, nonalcoholic fatty liver disease (NAFLD) is grossly underdiagnosed in the United States. (2020-05-06)

Rheumatoid arthritis patients on medicare seeing increased costs for specialty medications
After a sharp drop in out-of-pocket costs between 2010 and 2011, Medicare patients who use specialty biologic medications for rheumatoid arthritis have seen higher out-of-pocket spending for those same drugs because of gradual price increases, a new study in the Journal of the American Medical Association Open finds. (2020-05-01)

Medicare coverage varies for transgender hormone therapies
A new study has shown substantial variability in access to guideline-recommended hormone therapies for older transgender individuals insured through Medicare. (2020-04-13)

Medicare changes may increase access to TAVR
The number of hospitals providing TAVR could double with changes to Medicare requirements. Researchers see reason for both excitement and concern. (2020-04-06)

Adding a measure of patient frailty to Medicare payment model could lead to fairer reimbursement for clinicians
Researchers identified a way to measure frailty using patients' medical claims that more accurately predicts costs-of-care, especially for clinicians with disproportionate shares of frail patients. Adding this measure to Medicare's value-based payment models could lead to fairer reimbursement for clinicians who care for patients with greater needs. Findings from a retrospective cohort study are published in Annals of Internal Medicine. (2020-04-06)

Half of 65+ adults lack dental insurance; poll finds strong support for Medicare coverage
Nearly all older Americans support adding a dental benefit to the Medicare program that covers most people over age 65, according to a new national poll that also reveals how often costs get in the way of oral health for older adults. (2020-03-24)

Capping out-of-network hospital bills could create big savings
Placing limits on what hospitals can charge for out-of-network care has been proposed by some groups and a few health plans including Medicare Advantage already enforce such caps. But little is known about what role such an approach might play in driving down payment rates nationally. A new study finds that out-of-network billing caps could yield savings similar to more-sweeping proposals such as Medicare for All. (2020-03-12)

Study unveils striking disparities in health outcomes among 2 populations
In a new study published today in JAMA, a team of researchers at BIDMC evaluated how health outcomes for low-income older adults who are dually enrolled in both Medicare and Medicaid have changed since the early 2000s, and whether disparities have narrowed or widened over time compared with more affluent older adults who are solely enrolled in Medicare. (2020-03-11)

Differences between self-identified general practitioners and board-certified family doctors
Physicians who identify as 'general practitioners' are a group distinct from board-certified 'family physicians,' according to a new study that was supported, in part, by the American Board of Family Medicine Foundation. The authors recommend that GPs and FPs be considered separate groups for research, workforce and policy purposes. (2020-03-09)

Study shows dietitians are an effective part of weight loss
A new study in the journal Family Practice indicates that intensive behavioral therapy from dietitians may be a very effective ways for older Americans to lose weight. (2020-02-20)

PSU study finds out-of-network primary care tied to rising ACO costs
Accountable Care Organizations -- or ACOs -- formed for the first time in 2011, designed to combat rising medical costs and provide more coordinated care to Medicare patients. But the savings have been inconsistent nationwide. A new Portland State University study looked at what's driving those inconsistencies and what ACOs might do to resolve the issue. (2020-02-14)

Shingles vaccine may also reduce stroke risk
The shingles vaccine appears to reduce stroke risk by about 16% in older adults. In addition, the shingles vaccine may offer the strongest protection against stroke for people younger than 80. (2020-02-12)

Middle-aged adults worried about health insurance costs now, uncertain for future
Health insurance costs weigh heavily on the minds of many middle-aged adults, and many are worried for what they'll face in retirement or if federal health policies change, according to a new study. More than a quarter of people in their 50s and early 60s lack confidence that they'll be able to afford health insurance in the next year, and the number goes up to nearly half when they look ahead to retirement. (2020-02-07)

Inequitable medicare reimbursements threaten care of most vulnerable
Hospitals, doctors and Medicare Advantage insurance plans that care for some of the most vulnerable patients are not reimbursed fairly by Medicare, according to recent findings in JAMA. (2020-02-07)

For aging patients, one missed doctor's visit can lead to vision loss
Visit adherence plays an important role in outcomes for patients with age-related macular degeneration, a Penn Medicine study found. (2020-02-06)

Study finds association between therapy time, length of stay after hip fracture surgery
Researchers in the George Washington University Advanced Metrics Lab found that a hip fracture patient's length of stay in a rehabilitation facility has a greater impact on functional independence than therapy time per day (2020-01-27)

Medicare may overpay for many surgical procedures
For most surgical procedures, Medicare provides physicians a single bundled payment that covers both the procedure and related postoperative care over a period of up to 90 days. But a mounting body of evidence suggests that surgeons do not provide most of that postoperative care, suggesting changes are needed to make Medicare payments more equitable. (2020-01-22)

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