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Whitepapers, briefs, press releases and more
Analysis of 2023 MSSP Financial and Quality Results
The Medicare Shared Savings Program produced the largest savings in the program’s history in 2023, yielding more than $2.1 billion in net savings. Some key data relationships and statistical findings derived from the 2023 Performance Year Financial and Quality Results Public Use File (PUF) released by CMS on October 29, 2024, are as follows: regional ... Read more
Evaluating the Medication Adherence Impact of the Low-Income Drug Copay Waiver
Beginning in 2021, Medicare Advantage plans were allowed to waive Part D copay amounts for low-income members through the VBID model. This offering rapidly expanded, with 62 participating Medicare Advantage Organizations offering the benefit on their D-SNPs in the 2025 coverage year. This paper examines the impact of removing Part D copays on medication adherence ... Read more
Week in Washington 02/13/25
Congress House Republicans drafted a budget resolution that calls for $880 billion in federal spending cuts over 10 years to Medicaid. This would be about a 11% cut in federal Medicaid Spending and would likely require something like per capita caps to achieve. Several steps (vote to agree to the resolution, drafting legislation, ultimately passing ... Read more
Events & More
CY2025 Trends in Medicare Part D Plans
Wakely Webinar:
Wednesday, February 26- 1:00 PM ET
The Inflation Reduction Act’s Part D benefit redesign commenced January 1, 2025. As benefit design becomes more uniform across Part D plans, this webinar explores how sponsors adjusted the benefits of their plans to meet the requirements of the legislation, while still remaining competitive. We will review the CY2025 movements of Part D benefits and formulary placement, in addition to an assessment of the national stand-alone PDP landscape.
Newsworthy Findings
What Lies Ahead for Medicaid in Budget Reconciliation?
President Trump recently stated, “We will love and cherish” Medicaid, promising that budget cutting would be limited to finding waste and abuse. But that sentiment is not likely to prevail as Congress moves forward with massive budget cutting efforts, to be carried out in either one or two phases.
A Reinsurance Program to Mitigate Selection in Medicare Advantage
The Medicare Payment Advisory Commission (MedPAC) estimates that in 2024 CMS will pay MA plans $83 billion (22 percent) more than it would pay for comparable Medicare beneficiaries enrolled in Traditional Medicare. This problem could be mitigated by a global reinsurance program.
Trump Administration Healthcare Executive Orders Hit Snags in Court
The directives to limit publicly available healthcare data and cut federal funding for medical research have been temporarily blocked by federal judges.
Nearly Two-Thirds of Medicaid Beneficiaries Already Work: KFF
Most adults on Medicaid are employed, suggesting few beneficiaries wouldn’t meet a work requirement policy being considered by Republicans in Congress.
CVS Slashes Profit in 2024 as High Medical Costs Hit Aetna
CVS Health’s profits were nearly cut in half last year as the healthcare giant wrestled with elevated medical costs in its Aetna insurance business, particularly in Medicare Advantage and Medicaid.
Bonus Article
Fighting Cancer Without Fighting, Scientists Switch Tumor Cells Back to Healthy Ones at ‘Critical’ Moment
Just for Fun
Math Joke:
Where do mathematicians go on vacation?
Prior Week
Q: Why did the student do multiplication problems on the floor?
A: The teacher told him not to use tables
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