Medicare and Medicaid
Our work in Medicare and Medicaid
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Fixing Medicare Advantage With Competitive Bidding
Schaeffer experts recommend using competitive bidding for standardized benefits to set plan payments and enhance beneficiary choice in Medicare Advantage.
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Analysis: Competitive Bidding Vital to Ensuring Sustainability of Medicare Advantage
Schaeffer Center researchers detail how a competitive bidding structure – whereby plans compete on price and quality – would improve the MA program.
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Response to CMS Request for Information on Medicare Advantage Data
Schaeffer Scholars provided recommendations on improvements related to publicly available data, as well as administrative Encounter and Part D data.
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Shingles Vaccination in Medicare Part D After Inflation Reduction Act Elimination of Cost Sharing
Unlike commercially insured individuals who have no cost sharing for recommended vaccinations, in 2021, Medicare beneficiaries receiving vaccines covered under Medicare Part D paid $234 million out of pocket (OOP), with a mean OOP cost of $76.94 for shingles vaccines.
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Study: Shingles Vaccine Uptake Dramatically Increased After Inflation Reduction Act Removes Patient Out-of-Pocket Cost
Researchers from USC and University of Michigan say the study adds to “robust evidence” that eliminating costs helps patients access preventive services
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A Roadmap for Improving Medicare’s Application of Coverage With Evidence Development
CED has the potential to improve access to technologies, promote innovation, and drive evidence generation. However, CMS, manufacturers, researchers, policy makers, patients, and others must first work together.
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Improving Access to Medigap When Beneficiaries Leave Medicare Advantage
For beneficiaries switching from Medicare Advantage, state regulations generally permit Medigap plans to deny coverage, impose waiting periods, or charge higher premiums.
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Medicare Can Follow Blazed Trails to Revitalize Alzheimer’s Care
If Medicare is allowed to step up to the challenge of Alzheimer’s, patients could receive affordable and good quality care as soon as their disease develops.
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Comparative Effectiveness of Placental Allografts in the Treatment of Diabetic Lower Extremity Ulcers and Venous Leg Ulcers in U.S. Medicare Beneficiaries: A Retrospective Observational Cohort Study Using Real-World Evidence
DLEUs and VLUs treated with vCPM and vLPM allografts are associated with lowered 1-year mortality, wound recurrence, and AOs in DLEUs and VLUs compared with standard care. Decision makers weighing coverage of placental allografts should consider these added short- and long-term clinical benefits relative to costly management and high mortality of Medicare’s most frequent wounds.
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Medicare Coverage of Weight Loss Drugs Could Save the U.S. Billions of Dollars
The new weight loss drugs work, and represent huge value in treating obesity. Even though they are expensive, broader access to them via Medicare would end up saving the U.S. money.
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