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.
February 4th 2026
Beneficiaries in ACOs receive significantly higher rates of primary and preventive services, signaling value-based care’s impact on quality and chronic disease management.
Democratic Doctors Caucus Reaffirms EMTALA Amid Trump's CMS Policy Reversal on Abortion Care
June 18th 2025Democratic leaders assert the Emergency Medical Treatment and Labor Act (EMTALA) remains vital for emergency care, countering confusion from recent policy changes affecting abortion rights and patient safety.
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Strategies to Address Veteran Health Disparities Beyond the Battlefield
May 30th 2025Despite their profound sacrifices, veterans and active military members disproportionately face significant physical and mental health issues stemming from their service, with many struggling to access the affordable and comprehensive care they need.
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Health Policy in Flux: Trump Administration Updates
May 20th 2025HHS announces it is taking steps to implement President Trump’s Executive Order on prescription drug pricing. Keep up with the latest moves made in health policy under President Donald Trump's second administration. This timeline will be updated as orders and policy progress.
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Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare
Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
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Evaluating Access to Care for Medicare Beneficiaries Younger Than 65 Years
Enrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.
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Can Medicare Sustain Widespread Access to GLP-1 Therapies?
April 25th 2025Expanding Medicare coverage for glucagon-like peptide 1 (GLP-1) receptor agonists could significantly reduce obesity-related health issues, but it also risks adding tens of billions in new costs, highlighting the need for smart policy strategies to ensure access, affordability, and long-term sustainability.
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Survey Finds Slow Start on CMS Interoperability Rule Implementation
April 10th 2025With deadlines looming in 2026 and 2027 for compliance with the CMS Advancing Interoperability and Improving Prior Authorization Final Rule, a survey indicates a concerning lack of readiness among payers and providers to meet the new requirements for data sharing.
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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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The IRA’s Unintended Consequences for Drug Pricing and Coverage
April 2nd 2025The Inflation Reduction Act (IRA) may be restricting Medicare Part D formularies, increasing patient costs, and stifling pharmaceutical innovation, experts warned at the Academy of Managed Care Pharmacy 2025 annual meeting.
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Texas Oncology to Roll Out Canopy for ePROs After Head-to-Head Pilot
March 18th 2025Debra Patt, MD, PhD, MBA, executive vice president of Public Policy and Strategy for Texas Oncology, said the practice received positive feedback from nurses and patients during a pilot that concluded in February.
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More Care Doesn't Equal Happier Patients in Traditional Medicare
March 17th 2025Data on care satisfaction, ease managing care, and out-of-pocket spending were the outcomes of interest for this new analysis that investigated the relationship between healthcare utilization and beneficiary experience within traditional Medicare.
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Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being
March 14th 2025Mehmet Oz, MD, the nominee to lead CMS under the Trump administration, testified in a confirmation hearing before the Senate Finance Committee, where he found common ground on improving outcomes through healthier lifestyle choices but encountered repeated questions on potential Medicaid cuts.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk
Medicare beneficiaries treated by physicians with high levels of Medicare Advantage risk exposure had higher care quality and efficiency outcomes compared with those treated by other physicians.
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OIG Report Seeks Better Oversight, Records for FDA’s Accelerated Approvals
February 3rd 2025Amid the uproar over the firing of 18 inspectors general, a report offering a coda to the aducanumab approval episode has been overlooked. It shows the need for reforms of the FDA's accelerated approval process.
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Executive Orders Suggest Swift Pivot in Managed Care and Health Policy
January 22nd 2025President Donald Trump's initial executive orders target previous efforts to reduce health care costs, pandemic preparedness, and international partnerships, showing a stark contrast to the Biden administration.
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Health Equity & Access Weekly Roundup: January 11, 2025
January 11th 2025ACA enrollment rate hits a milestone, though IRA subsidies may not extend beyond 2025; network adequacy standards fail to translate into efficient access to mental health care for Medicaid enrollees; research examines racial disparities in postpartum hypertension and vaccine uptake.
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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care Organization
High-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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Year-End Spending Bill to Feature Reforms for Pharmacy Benefit Managers and Telehealth Access
December 18th 2024The health care provisions include key reforms targeting pharmacy benefit managers, extensions of Medicare telehealth flexibilities, and measures aimed at combating the opioid crisis and preparing for future pandemics.
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