The AJMC® Medicare compendium is a comprehensive resource for clinical news and expert insights on issues that affect Medicare beneficiaries with a focus on polypharmacy, reimbursement challenges, and other topics related to seniors.
May 6th 2024
The Medicare trust fund is now expected to deplete in 2036, with the Inflation Reduction Act being credited for at least some of the extension.
February 14th 2024
An Analysis of Medicare Accountable Care Organization Expense Reports
The authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
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With No Replacement for OCM on Horizon, Oncology Practices Ask: What Now?
November 22nd 2021The announcement of a "strategic refresh" for payment models under the Center for Medicare and Medicaid Innovation offered no details on what practices should expect when the Oncology Care Model (OCM) expires in 2022.
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US Oncology Network, Tennessee Oncology Tout Medicare OCM Savings
November 20th 2021A report from the Centers for Medicare and Medicaid Innovation confirmed that practices within the US Oncology Network and Tennessee Oncology participating in the Oncology Care Model (OCM) program have contributed significant savings to the agency.
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With Diversification Advisory Council, SCAN Group Plans for Growth in Care for Older Adults
November 17th 2021To guide its growth and its forays into home-based care, SCAN Group recently announced a Diversification Advisory Council, a group of 6 leaders from inside and outside health care with expertise in health care technology, reimbursement, and consumer engagement.
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COVID-19 prompted CMS to make major adjustments to the Medicare Advantage (MA) Star Ratings System, resulting in better-than-average performance for nearly all plans. However, these changes were temporary, and MA plans will have to reset their strategies for 2023 and beyond.
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A National Perspective of the Opportunities, Challenges Facing Health Care Cost and Sustainability
November 11th 2021Michael E. Chernew, PhD, co-editor-in-chief of The American Journal of Managed Care®, discussed cost and sustainability issues specific to commercial insurance, Medicare, and Medicaid at the National Alliance 2021 Annual Forum held in a hybrid format in Washington, DC.
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Anticholinergic Polypharmacy in Medicare Not Common but Still Problematic, Study Says
November 10th 2021The share of patients meeting the definition of polypharmacy for the condition of overactive bladder declined from 2006 to 2017, but the phenomenon was still prevalent in women and patients in nursing homes, according to a recent study.
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ADA vs CBO: Including Dental Coverage Under Medicare
October 2nd 2021The Congressional Budget Office (CBO) estimated that adding dental, vision, and hearing benefits would increase Medicare’s direct spending, but the American Dental Association (ADA) is claiming reimbursement will not be enough to cover these costs
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Study Contradicts Other Research About Potentially Inappropriate Medications Among Older Adults
September 22nd 2021The current study found that those prescribed potentially inappropriate medications were actually less likely to revisit the emergency department within 30 days, in contrast to prior work.
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BPCI Model Not Equipped to Tackle Reform of SNF Spending, Researchers Find
September 17th 2021The study found that BPCI Model 3, which held postacute facilities accountable for costs of care, was not associated with payment reductions or changes in other quality and selection metrics among skilled nursing facilities.
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Consumer Data Transparency Is More Important Than Ever as the Battle Against COVID Rages On
September 6th 2021On January 1, CMS implemented the Hospital Price Transparency final rule, but by July, it was clear that many hospitals were noncompliant. Even with a proposed rule for penalties, requirements still only fall on certain parts of the health care industry.
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