Medicare and Medicaid
Our work in Medicare and Medicaid
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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.
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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.
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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.
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The Agency Keeping Alzheimer’s Drugs from Patients
The Centers for Medicare and Medicaid Services refuses to approve breakthrough drugs.
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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.
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Alternatives to the QALY for Comparative Effectiveness Research
We now have useful and valid alternatives that allow for the assessment and valuation of treatments that improve population health without discriminating against vulnerable patient populations.
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Medicare Coverage of Weight Loss Drugs Could Significantly Reduce Costs
USC Schaeffer white paper finds that increasing access to obesity treatments would help save lives and reduce healthcare costs.
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Benefits of Medicare Coverage for Weight Loss Drugs
The cumulative social benefits from Medicare coverage for new obesity treatments over the next 10 years would reach almost $1 trillion, or roughly $100 billion per year.
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Comments to CMS on the Inflation Reduction Act’s Drug Price Negotiation Program
Over 20 researchers cosigned a comment letter to Centers for Medicaid and Medicare Services providing recommendations for the Medicare Drug Price Negotiation Program
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Prescription Drug Advertising and Drug Utilization: The Role of Medicare Part D
This paper examines how direct-to-consumer advertising (DTCA) for prescription drugs influences utilization by exploiting a large and plausibly exogenous shock to DTCA driven by the introduction of Medicare Part D.
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