Today in Medicare

Medicare programs compete

American Health Care Act could chip away at Medicare Savings Programs

BY MAURA CALSYN AND STACY SANDERS: The breakneck speed and secrecy surrounding the bill’s construction left little time to unpack how Medicaid per capita caps would affect the many populations, including older adults, people with disabilities, families, and children, who rely on Medicaid to afford quality health care. This includes the 11 million Americans—older adults and people with disabilities—who are enrolled in both Medicare and Medicaid. Of these millions of dually eligible beneficiaries, roughly 80 percent qualify for help paying for their Medicare coverage through the Medicare Savings Programs (MSPs). The US Senate is now repeating this exact process, meeting in secret and rushing to vote on a bill that will dismantle the Medicaid program. (read more)

Medicare coverage rules need better explanation from employers

BY GARY BOATMAN: Almost everyone must go on Medicare when they reach age 65. The only exception is if you or your spouse is still working for a company with 20 or more employees. People who are already receiving Social Security are automatically enrolled unless they opt out because they have required coverage from an employer. While the government does a pretty good job of explaining these rules to people turning 65, companies do not do a good job of explaining to workers continuing to work past that age. (read more)

Medicare’s programs should compete

BY DAVID INTROCASO: Over the past two decades, Medicare has evolved into three separate programs or payment systems: fee-for-service (FFS), sometimes termed traditional Medicare; Medicare Advantage (MA); and the Medicare Shared Savings Program (MSSP), or accountable care organizations (ACOs). Regulations governing these three programs differ substantially.

Because of this, annual rule making for the Centers for Medicare and Medicaid Services (CMS) has become an increasingly exigent exercise. The agency needs to determine which beneficiaries in which program are eligible to participate in which demonstration, and it must also financially account for overlap when a beneficiary receiving care from one payment model is also participating in a payment demonstration.

As for taxpayers, their interest in maximizing Medicare’s value is largely left unaddressed. They are asked to look the other way while financing a Medicare program that is, in sum, under-performing and spending inefficient. (read more)

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Medicare World Editorial Team

The Medicare World editorial team works diligently to make sure our stories are informative, unbiased, and of utmost relevance to our readers. Our team of researchers and writers presents the best and latest information on all things Medicare, including legislation, enrollment rules, changes in coverage and costs, and health information. We enjoy keeping our readers up-to-date and helping them navigate the often-complicated Medicare maze.

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