According to a report from the Kaiser Family Foundation, insurers who participate in selling health insurance plans in the Affordable Care Act (ACA) markets have collected more premiums than needed. The report estimates that insurers have collected an excess of $800 million in premiums and are expected to give these premiums back to consumers as [...]
The Centers for Medicare and Medicaid Services (CMS) has been working to continually evolve and reform the Accountable Care Organizations (ACOs) program. A recent reform to the ACO program was the Pathways to Success Rule, which was enacted in late 2018, which focused on reforming the Medicare Shared Savings Program (MSSP). The Pathways to Success [...]
The Centers for Medicare and Medicaid Services (CMS) is considering eliminating their current star rating model for a model that takes the average of scores, rather than their current model based on a latent variable model (LVM). The decision would not be quick, but would be enacted in 2020. The CMS' new stance on their [...]
On January 14, 2019, the House Democrats developed a draft for the approaching Medicare for All bill, which will suggest a new budget model. Initially, Senator Bernie Sanders had developed the framework for the Medicare for All bill in 2017, but the new draft expands on the funding for the bill. Sanders' bill had put [...]
The Centers for Medicare and Medicaid Services (CMS) had announce on Thursday the second part of their 2020 Medicare Advantage Advance Notice, which will increase the Medicare Advantage rates by 1.59% in 2020. The rate hike is not as substantial as the rate hike for 2019, which is 3.4%. The first section of the 2020 [...]
A new survey released by the Gallup National Health and Well-Being Index on Wednesday revealed that the number of uninsured American adults has increased from 10.9 % in 2016 to 13.7 % in 2018, which is a growth of an estimated 7 million adults uninsured. The current uninsured rate of 13.7% American adults is the [...]
On Thursday, the Center for Medicare and Medicaid Services (CMS) announced a proposed rule that aims to cut fees for those enrolled in the Affordable Care Act (ACA). This act can potentially eliminate silver-loading within the health insurance market. The practice of silver-loading is when premiums are heavily increased onto silver-level exchange plans, which are [...]
According to an update from Thursday from the Centers for Medicare and Medicaid Services (CMS), Healthcare.gov enrollment numbers drop compared to enrollment numbers in 2018. The update showed that 8.4 million Americans had enrolled in a health plan for 2019, which is down 3.8% from the enrollment count last year, which is more than 8.7 [...]
According to the new annual report published by the Centers for Medicare and Medicaid Services' Office of the Actuary, the U.S. healthcare spending growth had decreased from 2016 to 2017. Factors that had caused the decline in healthcare spending was the reduced use of hospital care, physician services and prescription drugs. In 2017, the annual [...]
In a report to Congress, the Centers for Medicare and Medicaid Services (CMS) stated that telehealth has the potential to provide valuable care without an increase in cost. Although promising, telehealth has yet to be adopted across Medicare beneficiaries. Within 2014 to 2016, less than one percent of all Medicare beneficiaries, which is estimated to [...]