Mortality, Medical Coding and the (Purported) Drop in Hospital Readmission Rates

Hospital readmission measures have been touted not only as a quality measure, but also as a means to bend the healthcare cost curve. The Affordable Care Act (ACA) established the Hospital Readmission Reduction Program (HRRP) in 2012. Under this program, hospitals are financially penalized if they have higher than expected risk-standardized 30-day readmission rates for […]

The High Cost of End-of-Life Healthcare – Myth?

There has been a lot of talk and presentation on End of Life care and its high costs. “The Myth Regarding the High Cost of End of Life Care” reviews those costs and expands the topic beyond End of Life to all the population with chronic conditions and functional limitations. FIGURE 1 Estimated overlap between […]

The Evolution of Private Plans in Medicare

Issue: Since the 1980s, private plans have played an increasingly important role in the Medicare program. While initially created with the goals of reducing costs, improving choice, and enhancing quality, risk-based plans — now known as Medicare Advantage plans — have undergone significant policy changes since their inception; these changes have not always aligned with the […]

Trumpeted New Medicare Advantage Benefits Will Be Hard For Seniors To Find

For some older adults, private Medicare Advantage plans next year will offer a host of new benefits, such as transportation to medical appointments, home-delivered meals, wheelchair ramps, bathroom grab bars or air conditioners for asthma sufferers. But the new benefits will not be widely available, and they won’t be easy to find. Of the 3,700 […]

Fixing Medicare Benefit Cliff Shouldn’t Give Cover for Drug Company Giveaway

Beneficiaries in Medicare’s prescription drug program (Medicare Part D) with high drug spending will have to pay much more out of pocket starting in 2020 under a scheduled sharp increase in the spending threshold at which catastrophic coverage kicks in. Policymakers may soon eliminate that looming benefit “cliff.” But they shouldn’t also reduce the discount […]