Articles related to MEDICARE

The $1.7 trillion spending bill signed by the president dramatically mitigates the expected cuts in Medicare payments. But any cut will still put an untenable strain on specialties like family medicine.

The new proposed rules are being cheered by caregivers and are in response to complaints from patients and providers that the PA process is often burdensome, disruptive to care, delaying care, costly, and a major source of frustration and burnout for providers.

Many prior studies associated enrollment in Medicare Advantage with lower use of health care services, greater performance of recommended preventive services, and higher scores for some measures of patient experience. This and other studies over the last decade suggest that “the association between Medicare Advantage and higher quality of care is modest at best.”

Medicare cuts will complicate the lives and precarious health circumstances of the millions of Americans who depend on it while undermining the quality of care for numerous diseases. As a result, the 4.5% reduction to therapy providers under the Medicare Physician Fee Schedule in 2023 is causing great worry among seniors and healthcare professionals countrywide. The physical and occupational therapy professions would see reductions of about 9% by 2024 if this cut were to go into effect.

Because a growing number of Medicare-eligible patients — currently 48% of 58 million beneficiaries — are enrolled in Medicare Advantage plans, the problem of “no prior authorization” happens increasingly frequently these days. Some medical professionals believe that before their gullible patients switch their coverage, they should make a special effort to inform them of the drawbacks of these plans.

A video conversation between a senior advisor at ADVI, a physician from Texas Oncology, and the division director of practice health for ASCO discuss the main provisions of the Inflation Reduction Act (IRA) and its implications for oncologists and oncology practices. The panel discusses why practices may have to bear a larger share of the cost of drugs and be ready for utilization cuts by focusing on two important aspects of the IRA: the $2,000 cap on patients’ out-of-pocket expenses and Medicare price negotiation. All three concur that if the act isn’t changed, it might slow down the development of medicines for some indications.