Today’s Hot Topics in Medicare News

Medicare’s annual health checkup: 5 things you need to know

BY Dan Caplinger: Nearly every American 65 or older relies on Medicare to meet a big portion of their health care needs. The program is one of the largest that the federal government runs, and Medicare plays a key role in how pharmaceutical companies and hospitals operate as well as what ordinary people need to do to have their medical needs met. Yet Medicare relies on funding that comes partly from payroll taxes and partly from general government outlays, and for a while now, Medicare’s financial future has come into question as health care costs rise.

Like Social Security, Medicare has trust funds that hold the money the federal government raises to support the program. Every year, the Centers for Medicare and Medicaid Services release a report that discusses the financial condition of Medicare’s trust funds, and just this past week, the 2019 report came out. At 249 pages, the full Medicare Trustees Report makes for a long read – but below, you’ll find some of the key facts you should know about where Medicare stands right now. (read more)

WellCare’s Medicare Enrollment Jumps As Centene Awaits

BY BRUCE JASPEN: Health insurer WellCare Health Plans Tuesday reported key growth in its Medicare and Medicaid businesses, a month after agreeing to be purchased by Centene.

The growth in the Medicare business, in particular, is key given that is an area Centene wants to bolster as part of its agreement to buy WellCare for more than $15 billion. Centene is perhaps best known for administering Medicaid benefits for poor Americans and sellingsubsidized individual coverage known as Obamacare in 20 states. (read more)

CPC+ Did Not Cut Medicare Spending, Improve Quality in First Year

BY JACQUELINE LAPOINTE: The Comprehensive Primary Care Plus (CPC+) did not affect total Medicare spending, and the value-based reimbursement program for primary care practices had little impact on service use and care quality, according to the program’s first annual evaluation report.

After accounting for enhanced CPC+ payments to practices, Medicare spending on beneficiaries treated by providers in CPC+ practices was actually two to three percent greater compared to program expenditures on beneficiaries treated at similar practices not in CPC+, the report shows. (read more)

With A Dig At Single Payer, Humana’s Medicare Advantage Business Booms

BY BRUCE JASPEN: Humana said its private Medicare Advantage business is on a roll as seniors flock to additional health benefits and care coordination.

The addition of more than 400,000 Medicare Advantage enrollees helped boost Humana first quarter profits and figure in the company’s decision Wednesday to raise its earnings outlook to the rest of the year to a range of $17.25 to $17.50 per share. (read more)

At $1.2 Billion, Massive Medicare Fraud Case May Just Be Tip Of Iceberg

BY PAM ZEKMAN and DAN BLOM: A record Medicare fraud bust–totaling $1.2 billion in wasted tax dollars–may just be the tip of the iceberg in a case that keeps raising troubling and expensive questions.

CBS 2 Investigator Pam Zekman reports it is a tale that begins with the arrival of a box.

“There is all kinds of goodies in here,” 77-year-old Paul Haak said after receiving his package.

“OK, let me see what this precious box has in it,” added 84-year-old Rosann Kelly. (read more)

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