Trump Administration Bumps Payment Rates For Medicare Insurers By 5%
The boost is double the one proposed in January by the Biden administration. Meanwhile, a study shows how UnitedHealth Group used certain strategies to get more money from Medicare Advantage.
The Wall Street Journal:
Private Medicare Plans To Get Big Payment Boost From Trump Administration
The Trump administration will substantially increase payment rates for Medicare insurers next year, generating more than $25 billion in additional revenue for the industry and doubling the boost proposed in January. The rate increase of 5.06%, compared with 2.23% in the earlier proposal from the Biden administration, overshoots even optimistic expectations from many Wall Street analysts, and will likely lead to a rally in the shares of big Medicare insurers such as UnitedHealth Group, Humana and CVS Health, parent of Aetna. (Wilde Mathews, 4/7)
On Medicare Advantage —
Stat:
Study Shows How UnitedHealth Uses Coding To Rake In Extra Cash From Medicare Advantage
Health insurers in the private Medicare business have a big incentive to diagnose their members with lots of health conditions: The government pays them more money. A new study shows the extent to which the biggest player in that business, UnitedHealth Group, stands out from the rest for its prowess at raking in extra cash from that program. (Bannow, 4/7)
Stat:
Republicans Are Proud Of Creating Medicare Advantage. Now Some Are Urging Reform Amid Runaway Costs
Republicans in Congress, long an unwavering source of support for privatized Medicare plans, are increasingly calling for reforms amid widespread evidence that health insurers are abusing the system to collect billions of dollars in unwarranted payments. (Ross, Bannow, Herman and Lawrence, 4/8)
KFF Health News:
Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers. Medicare Advantage plans pay hospitals lower rates than traditional Medicare, said Jason Merkley, CEO of Brookings Health System in South Dakota. Merkley worried the losses would spark staff layoffs and cuts to patient services. So last year, Brookings Health dropped all four contracts it had with major Medicare Advantage companies. (Zionts, 4/8)
In Medicaid news —
Modern Healthcare:
What The Senate Budget Resolution Means For Medicaid Cuts
Congressional Republicans agree that cutting taxes is their top priority, but the House and Senate have diverged on how, and how much, to cut Medicaid. The Senate approved a budget resolution in the early hours of Saturday that calls for $4 billion in spending cuts to offset a small portion of the $5.8 trillion cost for the tax cuts. By contrast, the House-passed budget resolution seeks at least $1.5 trillion in spending reductions including $880 billion from the Energy and Commerce Committee, which has jurisdiction over Medicaid. (McAuliff, 4/7)
The Hill:
GOP Pollster: Majority Of Trump Voters Oppose Medicaid Cuts
A majority of Americans who voted for President Trump oppose cuts to Medicaid funding, according to a recent poll. Two-thirds of surveyed swing voters oppose cutting Medicaid spending to pay for tax cuts, as do 51 percent of surveyed Trump voters, according to the poll conducted by the firm Fabrizio Ward. (O’Connell-Domenech, 4/7)
Politico:
Casey DeSantis’ Hope Florida Program Set For More Lawmaker Scrutiny Over Links To State Health Agency
Hope Florida will face further scrutiny this week over its relationship with the state Agency for Health Care Administration, with state lawmakers probing newly enacted requirements for Medicaid operators that include sharing patient data, incentivized participation and the transfer of $10 million last year. The program, led by first lady Casey DeSantis, aims to connect eligible residents in need with resources in the community. (Sarkissian, 4/7)
CalMatters:
How Medicaid Cuts Would Threaten California Mental Health System
Almost 15 million Californians are covered by Medicaid. Cuts to the program could weaken mental health programs that connect people with housing and treatment. (Ibarra, 4/7)
