Tag Archives: costs

Medicare announces coverage of costly Alzheimer’s medication. That could mean high premiums for beneficiaries

In the Alzheimer’s affected brain, abnormal levels of the beta-amyloid protein clump together to form plaques (seen in brown) that collect between neurons and disrupt cell function. Abnormal collections of the tau protein accumulate and form tangles (seen in blue) within neurons, harming synaptic communication between nerve cells. Image by National Institute on Aging, NIH via Flickr. Public domain photo

On June 1, Medicare officials announced plans to cover new FDA-approved drugs that may slow the progression of Alzheimer’s disease. The Centers for Medicare and Medicaid Services would also require patients using the drugs to register for the purpose of gathering information on treatment results.

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Teeth have an expiration date

Karen Michel

 Karen Michel

In the next few months, what I’ll be spending on fixing my teeth will eat up much of what I’ll earn this year, including Social Security benefits. I’m not alone in this dental distress. Those of us 65 and older will, for the most part, need more maintenance and replacement versus younger folks in that most visible part of our anatomy.

Nearly half of us don’t have dental insurance, according to a 2020 University of Michigan poll. Yet issues like dry mouth, root decay and gum disease are more common in older adults, researchers at the American Dental Association found. And the use of multiple medications can also lead to or exacerbate these conditions. That can mean older adults with chronic diseases like diabetes, heart disease or arthritis may be more prone to gum disease and other oral problems, but less likely to get dental care than their peers without these conditions, according to the CDC.

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Does care suffer as private equity firms buy struggling nursing homes?

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Photo: Gilbert Mercier via Flickr

Private equity firms are in the business of making money. On the surface, there is nothing wrong with that. However, a disturbing story in The Washington Post alleges that when private equity is involved in the buying and selling of nursing homes, things are often worse than they seem.

The story, by reporters Rebecca Tan and Rachel Chason, looks at Portopiccolo Group, which has a history of buying one- and two-star rated facilities. Continue reading

Experts have advice for the last-minute Medicare Advantage shoppers among your audience

A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.

A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.

Watching the TV ads during the evening news, you would think Medicare Advantage plans were the greatest health insurance bargain ever invented. Consumers should not be fooled, however.

It’s true that the federal Centers for Medicare and Medicaid Services made it possible for Medicare Advantage (MA) health plans to offer more benefits to seniors enrolled in Medicare. Some of these plans offer coverage for vision, hearing, and gym memberships) while not charging a monthly premium, and some MA plans will even pay for seniors’ Medicare Part B premium, said John Barkett, a senior director of policy affairs at the health care consulting firm Willis Towers Watson. Continue reading

Employers and insurers paid hospitals 247% more than Medicare rates, new study shows

Photo: stevenharman via Flickr

Research released today shows that from 2016 through 2018, self-insured employers and commercial health insurers in 49 states and the District of Columbia paid 247% more, on average, than what the Medicare program would have paid for the same inpatient and outpatient hospital services.

Researchers from RAND analyzed hospital claims data from 3,112 hospitals in every state except Maryland, which was excluded because the state has an all-payer rate setting model in which hospitals charge prices that are equal to what Medicare and private insurers pay, the report explained. The claims totaled $33.8 billion and came from self-insured employers, six state all-payer claims databases and health plans from 2016 to 2018. Continue reading