From 2010 to 2017, Medicare spending on the monthly prospective payments grew rather slowly, and average premiums for Medicare Part D enrollees remained between $30 and $31 per month. However, Medicare spending on reinsurance payments for enrollees with high drug costs grew on average more than 20% per year since 2010. In this blog post, we discuss several factors that have contributed to that high growth in recent years.
News
Trends in Medigap Enrollment, 2010 to 2015
The number of beneficiaries with Medigap policies has been growing, both in absolute terms, and as a share of beneficiaries in fee-for-service (FFS) Medicare. At the same time, a greater share of those with Medigap have chosen Medigap policies that include some significant amount of beneficiary liability for cost sharing. This blog post examines these trends using annual Medigap policy sales data from the National Association of Insurance Commissioners (NAIC) covering the years 2010 to 2015.
Meeting highlight: hospital consolidation and its implications for Medicare
At its November public meeting, the Commission held a session to discuss hospital consolidation and its implications for the Medicare program. The Commission has been tracking trends in provider consolidation, Medicare and private insurer payment rates, and provider costs for many years. In this post, we pull together a variety of analyses from MedPAC and others for a comprehensive backgrounder on hospital consolidation and Medicare.
Data book highlight: Rates of low-value service use and spending in Medicare
On Friday, MedPAC released its July 2016 data book. The data book is an annual MedPAC publication filled with charts and tables presenting much of the information from our March report, plus more, in a convenient and accessible reference guide. In this post, we’re highlighting two charts (5-7 and 5-8) about low-value care that can be found in this year’s edition.
MedPAC releases drug briefings
When the Commission began its deliberations on drug policy, which ultimately shaped the contents of the June report, it started with two informational presentations that were intended to provide background and context for its discussions. The Commission is now releasing annotated versions of these presentations to serve as a resource for policymakers.
March 2016 report highlight: HRAs and risk adjustment
MedPAC’s March 2016 report contains two recommendations for the Medicare Advantage (MA) program. This post will focus on the MA recommendation pertaining to health risk assessments (HRAs).
Case mix, coding, and profitability in IRFs
The high margin for IRFs in 2014 indicates that, in aggregate, Medicare payments substantially exceed the costs of caring for beneficiaries. But margins differ considerably across IRFs. Since 2009, the aggregate margin for hospital-based IRFs—which account for 52 percent of IRF discharges—has been at or below 1 percent, while the aggregate margin for freestanding IRFs has been 20 percent or more. Further, since 2006, the disparity between hospital-based and freestanding IRFs’ margins has been widening. The growing disparity is likely due in part to differences in cost growth.
Including hospice benefit in the MA benefit package
The Medicare hospice benefit is not included in the Medicare Advantage (MA) benefits package. MA enrollees who elect hospice remain in their MA plans, but fee-for-service (FFS) Medicare pays for their hospice services. This carve-out of hospice from MA fragments care accountability and financial responsibility for MA enrollees who elect hospice.
Price growth of brand-name drugs and Part D
Evidence suggests that price growth for brand-name drugs is beginning to drive growth in average prices of all drugs covered under Part D.
MedPAC examines MA and Part D plan accessibility
Every year, the Commission provides a status report on the Medicare Advantage (MA) and Part D programs. These reports were presented at our December and January meetings. To monitor each program’s performance, we examine enrollment trends, and plan availability for the coming year, as well as a variety of other factors.