Medicare and Medicaid
Our work in Medicare and Medicaid
-
White House Names First 10 Drugs for Medicare Negotiations; USC Policy Experts Available to Discuss Market Impact
Medicare released the list of the first 10 drugs subject to price negotiations under the Inflation Reduction Act (IRA), aiming to reduce drug costs for Medicare enrollees and taxpayers.
Categorized in -
Estimates of Diagnosed Dementia Prevalence and Incidence Among Diverse Beneficiaries in Traditional Medicare and Medicare Advantage
The prevalence of diagnosed dementia among beneficiaries in MA was lower than in TM.
-
Comments to CMS on Proposed Guidance for Coverage with Evidence Development
Eleven Schaeffer fellows cosigned a comment letter to Centers for Medicaid and Medicare Services providing recommendations on the proposed Coverage with Evidence Development Guidance.
Categorized in -
Lowering Medicare Advantage Overpayments from Favorable Selection by Reforming Risk Adjustment
One potential path for reducing Medicare Advantage (MA) overpayments from favorable selection is reforming the current administered payment approaches linking spending in fee-for-service (FFS) to MA rates.
Categorized in -
Trends in the Level and Composition of Supplemental Benefits in Medicare Advantage
The study evaluates the growth in rebates and concomitant changes in supplemental benefit composition among health maintenance organizations (HMOs) and local preferred provider organizations (PPOs).
Categorized in -
Favorable Selection Ups the Ante on Medicare Advantage Payment Reform
Overpayment to Medicare Advantage plans due to favorable selection, “coding intensity” and rating bonuses could exceed $75B in 2023.
Categorized in -
Overpayments to Medicare Advantage Plans Could Exceed $75 Billion in 2023, USC Schaeffer Center Research Finds
Overpayments to Medicare Advantage plans now exceed 20% annually, underscoring the urgent need for reform.
Categorized in -
Medicare Advantage Enrolls Lower-Spending People, Leading to Large Overpayments
Favorable selection led to Medicare Advantage overpayments on the order of 14.4% in 2020.
Categorized in -
The Agency Keeping Alzheimer’s Drugs from Patients
The Centers for Medicare and Medicaid Services refuses to approve breakthrough drugs.
Categorized in -
Medicare’s ‘Coverage with Evidence Development’: A Barrier to Patient Access and Innovation
CMS should abandon CED or, at minimum, reform and restrict its use only for off-label applications of therapies.
Categorized in