CMS Ups Medicare Payments For At-Home Vaccinations
To increase vaccine incentives and availability, Medicare will now pay providers $75 per at-home vaccination -- almost double the previous $40 payment. Other Medicare news is on dental services and the big price tag of the newly approved Alzheimer's drug.
Modern Healthcare:
Medicare, Blue Cross Push Incentives To Spur Vaccination Rates
Medicare on Wednesday promised providers new incentives for vaccinating homebound beneficiaries. The move comes as part of a broader effort to increase access to vaccines prior to President Joe Biden's July 4 goal of having 70% of the population at least partially vaccinated. While Medicare previously paid $40 per at-home vaccination, CMS will now pay $75 per dose. (Gellman, 6/9)
The New York Times:
On Medicare And Need Dental Work? Beware A Big Bill
Ellen Phillips hasn’t eaten much solid food over the past year and a half. She has lost all of her upper teeth — badly infected, they had to be extracted in 2019. Her tongue is constantly swollen. ... But Ms. Phillips, of West Hartford, Conn., is enrolled in traditional Medicare — which pays for dentistry only in very limited circumstances. Her extractions were not covered, and she doesn’t expect Medicare will pay for her implants. Many Medicare Advantage plans, the managed-care alternative to traditional Medicare offered by private insurance companies, do include a limited amount of dental coverage. But none would come close to covering her needs. (Miller, 6/9)
Axios:
Price Of Alzheimer's Drug Aduhelm To Squeeze Medicare And Patients
More than 90% of people with Alzheimer's disease are 65 and older, which means Medicare (i.e., taxpayers) will shoulder the load for Aduhelm's $56,000 annual list price. Why it matters: Aduhelm could create massive strains on Medicare spending and could create financially ruinous prospects for patients and their families. (Herman, 6/8)
In updates on Medicare Advantage —
Modern Healthcare:
Clover Projects Direct-Contracting Will Outpace Medicare Advantage
Medicare Advantage startup Clover Health has doubled its managed lives with the advent of Medicare's new direct-contracting model, and it has enlisted two home-based care providers to help it find success under the program. The Nashville-based insurance company plans to pair certain high-risk patients under its direct contracting program with Spiras Health and Upward Health, who will provide in-home primary care. Clover is one of more than 50 companies participating in Medicare's Global and Professional Direct Contracting Model in 2021. Others include insurers like Humana and providers like Oak Street Health and VillageMD. (Bannow, 6/9)
Axios:
Scoop: Venture Firms' Latest $300M Medicare Advantage Bet
Virginia-based AllyAlign Health, a Medicare Advantage insurance company focused on senior housing, just raised a nearly $300 million funding round led by New Enterprise Associates. It's the latest example of investor interest in the Medicare population, and more specifically, in Medicare Advantage. (Reed, 6/10)
