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Friday, Oct 20 2023

Full Issue

House Weighs Medicare Pay Reforms For Doctors, But Costs Not Assessed

A House Energy & Commerce health subcommittee hearing Thursday discussed 23 bills or drafts that address how Medicare pays providers. Lawmakers face an end-of-year expiration when Medicare will cut payments to doctors in certain rural areas and labs.

The House Energy & Commerce health subcommittee kicked off its first hearing in four years on whether to reform the way Medicare pays doctors. But they didn’t discuss how to pay for those changes. Lawmakers brought up 23 different bills on the topic, many of which are drafts that haven’t been introduced. (Wilkerson, 10/19)

A Medicare proposal to help alleviate major shortages of cancer drugs and other essential medicines could disadvantage facilities serving vulnerable populations and instigate new supply issues, experts and hospital groups say. (Goldman, 10/19)

A new analysis backed by doctor lobbying groups suggest that physician-owned hospitals could have fueled about $1.1 billion in savings across 20 of Medicare’s most expensive conditions in 2019— though the hospital industry is sticking firm to its stance that the broadly restricted facilities are a detriment to the U.S. healthcare system. The technical report (PDF), commissioned by the Physicians Advocacy Institute and The Physicians Foundation, but conducted by researchers from UConn Health and Loyola University Chicago, concluded that the Medicare program and its beneficiaries’ total payments at traditional hospitals would have been 8.6% and 15.2% (depending on the condition) lower if reimbursed at the same rate as a physician-owned hospital (POH). (Muoio, 10/19)

Walgreens and Alignment Healthcare have signed an agreement to offer new $0-premium co-branded Medicare Advantage plans in select markets throughout Arizona, California, Florida and Texas starting January 1, 2024. This will reach about 1.6 million Medicare-eligible adults, pending regulatory approvals, the companies said. Dawn Maroney, president, markets of Alignment Healthcare, and CEO of Alignment Health Plan, said the goal is to deliver better access, and to make it more convenient and cost-effective for seniors to get their medicine. (Lagasse, 10/19)

Â鶹ŮÓÅ Health News' 'What The Health?' Podcast: The Open Enrollment Mixing Bowl 

Autumn is for pumpkins and raking leaves — and open enrollment for health plans. Medicare’s annual open enrollment began Oct. 1 and runs through Dec. 15. It will be followed shortly by the Affordable Care Act’s annual open enrollment, which starts Nov. 1 and runs until Jan. 15 in most states. But what used to be a fairly simple annual task — renewing an existing health plan or choosing a new one — has become a confusing, time-consuming mess for many, due to our convoluted health care system. (10/19)

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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