Week in Washington 081023

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington

08/10/2023

Medicaid Redetermination

Medicaid redetermination data continued to have large Medicaid disenrollment numbers. Since the unwinding of Medicaid began back in April, at least 4.1 million Medicaid beneficiaries have been disenrolled. This includes over 500 thousand kids. CMS sent letters to states on compliance issues. You can read the letters here. It’s important to note that Medicaid redetermination effects are not confined to Medicaid. According to early CMS data, approximately 8% of those being disenrolled in Medicaid selected an Exchange plan. There are also implications for MA/Part D plans as member’s subsidy calculations could be highly volatile/incorrect, which has implications for access and care.

Weight Loss Drug

Novo Nordisk’s weight loss drug, Wegovy, demonstrated substantial heart health benefits. Specifically, the drug was found to reduce the risk of heart attacks by 20%. The findings could put pressure on commercial insurers to cover the $1,300 a month drug as well as pressure on lawmakers to make changes to Medicare to increase coverage of weight-loss drugs.

Quality Bonus Payments

KFF released new research on spending on Medicare Advantage Quality Bonus payments. Their research found that payments will reach at least $12.8 billion. There is growing discussion about changing to the Quality Bonus program given increases in payments.

Inflation

Mixed inflation news this week. Core inflation (inflation excluding fuel and food) which is what the Federal Reserve uses to make decisions showed good signs of cooling inflation. This could result in the Federal Reserve pausing interest rate increases.  Medical services cost also show signs of picking up.

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