Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Retracts Medicare Advantage Enrollment Report For Corrections
Modern Healthcare: Medicare Advantage 2025 Enrollment Data Retracted By CMS
The Centers for Medicare and Medicaid Services withdrew an eagerly awaited report detailing how health insurance companies fared during the Medicare Advantage annual enrollment period after identifying faults in the data Wednesday. The agency plans to issue a corrected report next week, according to a notice CMS published several hours after releasing the enrollment figures. (Tepper, 1/15)
Modern Healthcare: Medicare ACO Growth Inches Toward CMS's Value-Based Care Goal
More than half of fee-for-service Medicare enrollees are now in accountable care arrangements, putting the Centers for Medicare and Medicaid Services past midway toward its 2030 goal, according to data the agency released Wednesday. Accountable care participation rose 4.3% to 14.8 million people from 2024 to 2025, the largest annual increase since CMS started tracking these numbers. That amounts to 53.4% of fee-for-service beneficiaries, according to the agency. (Early, 1/15)
MedPage Today: Supplemental Benefits Offer Few Advantages For MA Enrollees
Even though almost all Medicare Advantage (MA) plans boast coverage of supplemental benefits -- dental, vision, and hearing -- enrollees didn't get more care, and they spent just as much out of pocket as those with traditional Medicare, a cross-sectional study showed. MA and traditional Medicare enrollees had "virtually identical" rates of using hearing aids (13.4% and 13.2%), wearing eyeglasses (78% and 76.8%), and having an eye exam in the past year (53.5% and 53.6%), according to Christopher Cai, MD, of Brigham and Women's Hospital in Boston, and colleagues. (Fiore, 1/15)
Modern Healthcare: JPM 2025: Alignment Reaffirms Medicare Advantage Goals
Alignment Health remains committed to balancing margin expansion with membership growth this year, executives told investors Wednesday during the first of two health insurer presentations at the J.P. Morgan Healthcare Conference. "We're never going to swing to a growth at all-cost mentality,” Chief Financial Officer Thomas Freeman said. “At the same time, we're not going to shoot for a profitability at all-cost mentality either." (Berryman, 1/15)
CNBC: Medicare $2,000 Prescription Drug Cap May Save Enrollees Thousands: AARP
Most Medicare patients who hit the new $2,000 cap on out-of-pocket spending for prescription drugs could see massive savings, despite changes in premiums, according to a report released Thursday by AARP. (Constantino, 1/16)
In Medicaid news —
AP: New Mexico State Spending Plan Seeks More Federal Medicaid Dollars As Donald Trump Takes Office
Leading New Mexico legislators on Wednesday recommended a 5.7% general fund spending increase for the coming fiscal year that emphasizes health care access, public school improvements, and early education and childcare programs that can boost household finances. The lead budget writing committee to the Democratic-led Legislature proposed a $577 million increase to $10.8 billion for the fiscal year running from July 2025 to June 2026. A windfall in government income from petroleum production is slowing down though far from over in New Mexico, the nation’s No. 2 oil-producing state. (Lee, 1/16)
AP: Some Parents Could Be Able To Join Georgia's Medicaid Program Without Working
Georgia Gov. Brian Kemp announced Wednesday he wants to let low-income parents with young kids enroll without working in a Medicaid program that provides coverage for some able-bodied adults. ... Georgia is the only state that requires some people to work, study or volunteer to enroll in Medicaid, under the program Georgia Pathways. If the incoming Trump administration approves Kemp’s plan, parents and guardians of kids up to age 6 in households at or below 100% of the federal poverty level could receive Medicaid without meeting those requirements. (Kramon, 1/16)
