Medicare and Medicaid
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Improving Medicare Advantage by Accounting for Large Differences in Upcoding Across Plans
A two-pronged reform strategy can limit the competitive edge for Medicare Advantage plans that aggressively upcode while lowering overpayments.
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Comments to CMS on Proposed Medicare and Medicaid Coverage of Anti-Obesity Medications
Schaeffer Center research shows expanding access to breakthrough anti-obesity medications can broadly generate positive social returns while potentially shrinking health disparities.
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Medicare Drug Price Negotiations Need Something New: A Floor
Adding a floor price mechanism would protect valuable innovation and effectively give future generations of patients a seat at the negotiating table.
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Medicare Advantage Enrollment Has Surged. Big Savings for Beneficiaries Help Explain Why.
A typical enrollee could save about $140 per month by picking a Medicare Advantage plan over traditional Medicare. Policymakers considering MA reform shouldn’t overlook the program’s greater financial generosity.
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The nation’s growing debt threatens Medicare and Medicaid, which have helped countless Americans and reduced poverty. Schaeffer Center researchers work with legislators on a bipartisan basis to bolster these vital systems, making them more efficient and effective.
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Medicare Should Cover Wegovy — but Not Negotiate Its Price
Subjecting Wegovy to price controls would crush innovation and discourage new entrants to this important new class of anti-obesity medications that could help millions of Americans.
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Medicare Enrollment Linked to Sharp Decline in Use of Mental Healthcare Services
People with substantial mental health needs appear to receive much less mental healthcare after they age into Medicare, while use of non-mental healthcare is unaffected.
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Out-Of-Network Utilization and Plan Selection Among Medicare Advantage Cost Plan Enrollees
Provider networks in Medicare Advantage not only appear to impact health care use but can also impact the types of beneficiaries who choose to enroll in traditional Medicare versus MA.
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Enrollment in Medicare is Associated with Fewer Outpatient Mental Healthcare Visits among Those with Mental Health Symptoms
Enrolling in Medicare is associated with a reduction in the use of mental healthcare among individuals with probable mental health symptoms and low or moderate family incomes.
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Government Needs to Do More to Ensure Obesity Drug Safety
Expanding coverage for anti-obesity medications without reforming compounding regulation will exacerbate problems with counterfeit drugs. The incoming administration should modernize manufacturing techniques, shore up the supply chain and ban compounding of new obesity medications.
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Comments to CMS on Proposed $2 Drug List Model
Transparent, simple plan benefits like the proposed model, as well as transparent cost structures throughout the system, have valuable impacts for the beneficiary and the potential to help align incentives throughout the distribution system.
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