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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, Feb 23 2016

Full Issue

CMS Proposal Would Cut Payments To Medicare Advantage Plans Sponsored By Employers

The proposal would change the bidding process for plans sponsored by employers and unions for retirees. Meanwhile, The Associated Press examines how the Centers for Medicare & Medicaid Services' favorable assessment of factors affecting rates is playing out with other Medicare Advantage plans. In other marketplace news, a group calls for the creation of long-term care insurance plans similar to Medicare, CVS health says it toned down its prescription drug spending, and the new leader at Zenefits tries to rein in the rambunctious culture at the startup.

A new federal proposal would slash overpayments made to Medicare Advantage plans sponsored by employers and unions years after an advisory board recommended the policy. The CMS proposed terminating the bidding process for employers and unions that offer 2017 Medicare Advantage plans to their retirees. The policy was included in the recent 228-page Medicare Advantage rate notice (PDF). Instead of bidding, those plans would receive predetermined payments that would, in essence, lower their revenue. (Herman, 2/22)

Medicare Advantage health plans will face less pressure to cut benefits or leave some markets next year after the government released a favorable early assessment of factors affecting rates. The Centers for Medicare and Medicaid Services laid out a payment and policy update for 2017 on Friday after markets closed. The announcement includes an assessment of several variables that can affect the price of coverage. Analysts say it boils down to a rate increase of around 3.5 percent when including adjustments made to account for the health of patients covered by a plan. (Murphy, 2/22)

The long-term care costs for our aging population are growing so fast and can be so financially overwhelming for families that the United States needs a universal catastrophic insurance program similar to Medicare, a bipartisan policy group announced Monday. The Long Term Care Financing Collaborative, which includes former state Medicaid directors, and members from the Brookings Institution, and the trade group America's Health Insurance Plans, is the third recent policy group to cite universal long-term care insurance as a possible solution — and the one that goes the farthest in recommending it. (O'Donnell, 2/22)

CVS Health is refining its prescription for controlling drug costs, and patients can expect more frequent coverage adjustments, as the pharmacy benefits manager pores over data and reacts to expense spikes. (Murphy, 2/23)

Zenefits’s new chief executive, David Sacks, last week banned alcohol in the office of the health-insurance brokerage startup as he tries to reverse its rambunctious culture, especially among sales staff. But it wasn’t just drinking booze that gave the San Francisco headquarters a frat-house feel. (Winkler, 2/22)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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