Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare Advantage Is A Fast-Growing, Lucrative Marketplace. But Is It Benefiting Patients Or Insurers More?
When Ed Stein signed up for Medicare eight years ago, the insurance choice seemed like a no-brainer. Mr. Stein, a Denver retiree, could choose original, fee-for-service Medicare or its private managed-care alternative, Medicare Advantage. He was a healthy and active 65-year-old, and he picked Advantage for its extra benefits. 鈥淭he price was the same, I liked the access to gyms, and the drug plan was very good,鈥 he recalled. After a pause, he added: 鈥淣ever in my wildest dreams did I think I鈥檇 be facing a crisis like the one I鈥檓 having now.鈥 (Miller, 2/21)
If you鈥檙e counting on working past your 65th birthday, be sure to consider how Medicare may factor into your plans 鈥 even if you already have health insurance through your job. While workers at companies with fewer than 20 workers generally must sign up for Medicare at age 65, people working for larger companies typically have choices: They can stick with their group plan and delay Medicare without facing penalties down the road, drop the company option in favor of Medicare or go with a combination of the two. (2/19)
In other news out of CMS 鈥
The CMS Center for Medicare and Medicaid Innovation on Thursday proposed a three-year extension for the comprehensive care for joint replacement model. The proposed rule seeks to change the definition of an episode to include outpatient hip and knee replacements. The agency also wants to modify how it calculates the basis for the target price by using the most recent year of claims data instead of the last three years, among other changes. (Brady, 2/20)
Kaiser Health News: Trump鈥檚 Medicaid Chief Labels Medicaid 鈥楳ediocre.鈥 Is It?
The Trump administration鈥檚 top Medicaid official has been increasingly critical of the entitlement program she has overseen for three years. Seema Verma, administrator of the Centers for Medicare & Medicaid Services, has warned that the federal government and states need to better control spending and improve care to the 70 million people on Medicaid, the state-federal health insurance program for the low-income population. (Galewitz, 2/21)
