Medicare Advantage plans may not be all they’re cracked up to be and often mislead consumers, according to a new MedPage Today story by reporter Cheryl Clark, who also is AHCJ’s new patient safety core topic leader. As Clark puts it, “getting out is a lot harder than getting in.”
Anyone turning 65 has several months on either side of their birthday to choose to enroll in traditional Medicare, the government-run health insurance for older adults and certain people under 65 with disabilities. Medicare includes Parts A (hospitalization), B (physician services) and an optional Part D (prescription drug plan). As of November, Medicare covered nearly 39 million people. Continue reading
One of the largest and most important parts of our health care system is the role employers play in providing health insurance coverage for workers, retirees, and family members. U.S. employers cover 55.1% of Americans who have health insurance, according to a report released by the U.S. Census Bureau.
By providing health insurance for more than half of all Americans, employers pay for the biggest share of health coverage in the United States. Continue reading
Knee replacement surgeries and stenting procedures will now be reimbursed in free-standing ambulatory surgery centers for Medicare fee-for-service beneficiaries as of Jan. 1 under a new rule finalized by the Centers for Medicare & Medicaid Services on Friday.
The controversial policy shift will mean hundreds, if not tens of thousands, of older patients will now have these complex procedures in a facility not attached to a hospital, and will go home the same day. Continue reading
Who reads Medicare rules?
They’re long, boring, hard to read because of the small type in narrow columns and they’re full of repetition and jargon.
But just in case you have a sleepless night, I recommend pulling up proposed or final rules for an IPPS, (inpatient prospective payment system) or an OPPS (outpatient prospective payment system) or a PFS (physician fee schedule), for starters. Continue reading
With the news out of Washington coming at us fast and furiously, it may have been easy to miss the introduction of House Speaker Nancy Pelosi’s new proposal to curb the cost of prescription drugs.
Drug pricing is an especially important issue for older adults, many of whom are on multiple medications and take more prescription drugs on average than any other age group in the United States, according to the American Geriatrics Society.
President Donald Trump has pledged to unveil a new plan to repeal and replace the ACA – but we haven’t seen it, and it’s not clear that we ever will. If the president does announce a plan, it’s to campaign on in 2020, not to try to enact before the November elections with a Democratic-controlled House and a divided Senate.
There’s no way to know how the Ukraine scandal will factor into health care and domestic policy. Trump may focus on impeachment and politics to the exclusion of health care – or he may try to change the subject with some kind of health platform. Continue reading