Expanding Medicare Drug Coverage May Spell Disaster, Policy Experts Warn
Adding expensive obesity drugs to the list of covered drugs could add tens of billions of dollars to the cost of Medicare and would likely lead to a rise in premiums, researchers say.
Reuters:
Economists Warn Of Costs If Medicare Covers New Obesity Drugs
The cost of expanding U.S. Medicare prescription drug coverage to pay for expensive, new obesity medications could be catastrophic, health economists warned in a report published on Saturday. (Lapid, 3/11)
Stat:
New Weight Loss Drugs Could Strain Medicare, Policy Experts Warn
Even a small amount of uptake would create significant costs for Medicare, likely leading the federal insurer to raise premiums in the long run, the researchers said in a perspective piece Saturday in the New England Journal of Medicine. The chronic medications may also have fewer benefits and more risks for older people — the population that Medicare serves, they wrote. (Chen, 3/11)
On Medicare Advantage —
Stat:
How Medicare Advantage Plans Use AI To Cut Off Care For Seniors
An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home. On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help. (Ross and Herman, 3/13)
Stat:
A Medicare Advantage Business Is Strangling One Of Its First Funders
When NaviHealth began building a business around using algorithms to scrutinize the care of older patients a decade ago, one of the country’s largest chains of inpatient rehab and long-term care hospitals was among the first to invest. Select Medical cut a check of about $5 million — a rounding error for a conglomerate that generates more than $6 billion of revenue every year. Now, years after exiting its investment, Select Medical is publicly bashing the company it once backed. (Herman and Ross, 3/13)
On President Joe Biden's budget proposal —
KHN:
Biden Budget Touches All The Bases
President Joe Biden’s fiscal 2024 budget proposal includes new policies and funding boosts for many of the Democratic Party’s important constituencies, including advocates for people with disabilities and reproductive rights. It also proposes ways to shore up Medicare’s dwindling Hospital Insurance Trust Fund without cutting benefits, basically daring Republicans to match him on the politically potent issue. (3/10)
NPR:
What President Biden And Republicans Are Saying About Funding Medicare
NPR's Michel Martin speaks with Kaiser Health News correspondent Julie Rovner about the politics of Medicare ahead of debt ceiling talks in Washington. (3/12)
In Medicaid news —
Modern Healthcare:
Health Industry Groups To Assist Medicaid Enrollees Losing Coverage
A coalition of healthcare organizations, led by the health insurance group AHIP, has come together to create a "one-stop shop" to assist millions of Americans facing disenrollment from Medicaid when states review their benefit rolls in the coming months. The Connecting to Coverage Coalition consists of 16 associations representing health insurance companies, providers and patients, including the Federation of American Hospitals, the American Health Care Association, the Catholic Health Association of the United States, and the American Cancer Society Cancer Action Network, AHIP announced Thursday. (Turner, 3/10)
