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IOM Panel Raises Concerns About Lowering Medicare Pay For High Spending Areas
An Institute of Medicine panel on Friday panned an idea that has been raised in Congress to pay Medicare providers in some areas of the country less if their regions are heavy users of medical services.
The idea is an outgrowth of decades of research into why Medicare spends more per beneficiary in some places such as New York City, Florida and McAllen, Texas, and significantly less in parts of Minnesota and Wisconsin. Much of those spending totals—20 to 30 percent by some estimates—cannot be explained by the age or health of residents, leading some analysts to surmise the extra spending is due to unnecessary services and waste.
Read the full story: http://bit.ly/ZFM7WV
Source: Kaiser Health News
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
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AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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