What you are reading here is a piece on the costs of Medicare Advantage Plans versus Traditional Medicare. Why is one so different than the other? The differences in MA and FFS are in coding intensity and selection. The later does not have such. MedPAC March 2025 report to the Congress Pages 338 to Page […]
In addition to mRNA vaccines and CAR-T cell therapy, semaglutides and tirzepatides offer transformative therapies, in this case for obesity and associated type-2 diabetes. But the drugs aren’t cheap, so access is a problem in the US. “Medicare will cover semaglutide (Wegovy) and tirzepatide (Zepbound) for their weight management indications for people with obesity, President […]
I broke this comment by Deb Schultz (comments section “Traditional Medicare Open Enrollment is Now”) into three different segments to emphasize each part. Deb and I talked once before. I agree with her comments. It is worth reading so you understand the issues. Please read. ~~~~~~~ “Is this open season for Traditional Medicare available only […]
Yes, it cuts Medicaid explicitly. But it will result in cuts to Medicare as well: “But now Republicans have created another problem. They didn’t just cut Medicaid; they also have forced nearly half a trillion dollars in cuts to Medicare, the health program for the elderly. “Because of a statutory requirement to automatically impose budget […]
Briefly, a fast read . . . Trumps extension of the 2017 Tax Cuts and Jobs Act (TCJA) is a $3.8 trillion extension of it which will mostly benefit the wealthy and corporations. Professor Heather at “Letters from an American” (to which I subscribe) had this to say yesterday about the extension current being passed […]
CEPR’s Brandon Novick wrote a piece on Medicare Advantage plans. It is brief enough to make for easy reading, It also gets to the point of Medicare Advantage plans. As it was commercial Medicare Advantage plans were overcharging for the same care Traditional Medicare would charge. In many cases the plans would not approve the […]
Semaglutides are turning out to be transformative for obesity in the way that statins have been transformative for hypercholesterolemia and anti-hypertensives have been transformative for high blood pressure: they’re not only highly effective but have minimal side effects. From a public health standpoint, there’s every reason to allow Medicare and Medicaid coverage for semaglutides. But […]
Social Security adjustments are coming up starting January 2025. As if typical the increase in payment did not keep up with inflation last year. If you have not been keeping track of forth coming Social Security changes in 2025, here they are: Starting in 2025, Medicare Part B premiums will increase from $174.70 per month […]
The Government made it possible for people to choose between Traditional Medicare and Medicare Advantage for their care at 65. An alternative was provided under the guise of commercial healthcare providing better healthcare and other services to those who qualify for Medicare at a lesser cost. There are superficial and also meaningful pluses that are […]
by Matthew Cunnigham – Cook The problems with Medicare Advantage is coding and pricing for care. And Fee for Service participants pay for the MA costs even though they do not use MA. “When accounting for favorable selection of enrollees in MA and higher MA coding intensity, we estimate Medicare spends approximately 22 percent more […]