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Thursday, Jan 16 2025

Full Issue

CMS Retracts Medicare Advantage Enrollment Report For Corrections

Meanwhile: Medicare Advantage enrollees aren't seeing expected savings on supplemental care; Inflation Reduction Act's annual prescription cap will provide significant savings; Georgia wants to change Medicaid eligibility requirements; and more.

The Centers for Medicare and Medicaid Services withdrew an eagerly awaited report detailing how health insurance companies fared during the Medicare Advantage annual enrollment period after identifying faults in the data Wednesday. The agency plans to issue a corrected report next week, according to a notice CMS published several hours after releasing the enrollment figures. (Tepper, 1/15)

More than half of fee-for-service Medicare enrollees are now in accountable care arrangements, putting the Centers for Medicare and Medicaid Services past midway toward its 2030 goal, according to data the agency released Wednesday. Accountable care participation rose 4.3% to 14.8 million people from 2024 to 2025, the largest annual increase since CMS started tracking these numbers. That amounts to 53.4% of fee-for-service beneficiaries, according to the agency. (Early, 1/15)

Even though almost all Medicare Advantage (MA) plans boast coverage of supplemental benefits -- dental, vision, and hearing -- enrollees didn't get more care, and they spent just as much out of pocket as those with traditional Medicare, a cross-sectional study showed. MA and traditional Medicare enrollees had "virtually identical" rates of using hearing aids (13.4% and 13.2%), wearing eyeglasses (78% and 76.8%), and having an eye exam in the past year (53.5% and 53.6%), according to Christopher Cai, MD, of Brigham and Women's Hospital in Boston, and colleagues. (Fiore, 1/15)

Alignment Health remains committed to balancing margin expansion with membership growth this year, executives told investors Wednesday during the first of two health insurer presentations at the J.P. Morgan Healthcare Conference. "We're never going to swing to a growth at all-cost mentality,鈥 Chief Financial Officer Thomas Freeman said. 鈥淎t the same time, we're not going to shoot for a profitability at all-cost mentality either." (Berryman, 1/15)

Most Medicare patients who hit the new $2,000 cap on out-of-pocket spending for prescription drugs could see massive savings, despite changes in premiums, according to a report released Thursday by AARP. (Constantino, 1/16)

In Medicaid news 鈥

Leading New Mexico legislators on Wednesday recommended a 5.7% general fund spending increase for the coming fiscal year that emphasizes health care access, public school improvements, and early education and childcare programs that can boost household finances. The lead budget writing committee to the Democratic-led Legislature proposed a $577 million increase to $10.8 billion for the fiscal year running from July 2025 to June 2026. A windfall in government income from petroleum production is slowing down though far from over in New Mexico, the nation鈥檚 No. 2 oil-producing state. (Lee, 1/16)

Georgia Gov. Brian Kemp announced Wednesday he wants to let low-income parents with young kids enroll without working in a Medicaid program that provides coverage for some able-bodied adults. ... Georgia is the only state that requires some people to work, study or volunteer to enroll in Medicaid, under the program Georgia Pathways. If the incoming Trump administration approves Kemp鈥檚 plan, parents and guardians of kids up to age 6 in households at or below 100% of the federal poverty level could receive Medicaid without meeting those requirements. (Kramon, 1/16)

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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