CMS Proposed Payment Increase for Medicare Advantage
The government has proposed increasing average payments to health insurers offering Medicare Advantage plans by 0.25%. According to Reuters, last year the proposed increase had been 1.35% before it was later reduced to 0.5%. As Republicans consider replacing or changing the Affordable Care Act, Medicare Advantage plans, which have seen increases in enrollment of 7% in the last year, will be increasingly important for insurers’ business.
Shulkin Promises No Privatization for VA
While President Donald Trump’s nominee to lead the Department of Veterans Affairs (VA) will enact sweeping changes, he will not privatize the department. David Shulkin, the current undersecretary of health for the VA, testified before the Senate Committee on VA and promised not to privatize the department during his tenure, reported The Wall Street Journal. Trump has expressed interest in further privatizing the VA, but Shulkin said he would oppose such efforts. Shulkin is a holdover from the Obama administration and had joined the VA in 2015.
A New Savings Account for People With Disabilities
The new Achieving a Better Life Experience (ABLE) account allows people with disabilities to save more money without losing government benefits. AP reported that the accounts are run by states, similar to 529 plans for college savings, and that eligible individuals would be able to save and still receive benefits such as Medicaid or Supplemental Security Income monthly payments. Only 16 states offer these accounts so far and only legal residents who had a disability before the age of 26 can open an account. The funds in the ABLE account can be used on any expenses that improve the life, independence, or health of the person with disabilities.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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