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Jan 16 2014

A statistical brief from AHRQ looked at trends in health expenditures for the over-65 population for 2001, 2006 and 2011, in constant dollars.  $414.3 billion was spent on health care for this population in 2011, $100 billion higher than in 2001.  Average per person expense was $9863 compared to $8815 in 2001.  The percent of people with an ER visit, inpatient stay or hospital outpatient visit declined from 2001 to 2011 and outpatient care and drugs accounted for more expense in 2011 than in 2001.  Average costs for all types of services were higher in 2011.  Medicare paid for 62.4% of the elderly's health expense in 2011 compared to 54.7% in 2001.

http://meps.ahrq.gov/mepsweb/data_files/publications/st429/stat429.pdf
Jan 15 2014

According to Mark Farrah Associates as of December 1, 2013, there were 15,146,000 people in Medicare Advantage plans, about a 9% increase over the same time last year.  UnitedHealth Group has about 21% of the market, followed by Humana with 16% and Kaiser with 8%.  Around 17% of MA enrollment comes from employer retiree group plans.  2014 open enrollment ended on December 7, so the early indications are that there was strong growth.

http://www.markfarrah.com/healthcare-business-strategy/
Jan 07 2014

MedPAC Fact Book on Dual Eligibles

https://a7d050c2-a-10078ef1-s-sites.googlegroups.com/a/macpac.gov/macpac/publications/Duals_DataBook_2013-12.pdf?attachauth=ANoY7cqXKnTKnMoO1LMbUcJwnRCboSVMIN0Aia1jXRCf2XBKztKx-67zZ0O-OXhwEbYrQc_U4ij26iiqRuQ-Cq1qOyK1WWDWKm2vthI24Q_aw6dBlIHVP-gyujPcnu7WcsFrbMdYmX2XOZFqw2r6aa3uKqAHvhm-Cj-kZhZxtPdlpx4aL7HyZGDKJAwqwPsGrRT1uB-7EZSez3PkxA1DAq1i3Od9pMHv_2pPMcY9ag2qOM97PMEyoig%3D&attredirects=1
Jan 03 2014

An Inovalon research brief suggests that dual eligibles are more complex to manage than other Medicare Advantage beneficiaries and that they tend to drag down a plan's STAR rating.

http://www.inovalon.com/Documents/2013/INV-Impact-of-Dual-Eligibles-on-Star-Ratings-(10.30.13)-v1.0.0.pdf
Dec 20 2013

Congress has passed a short term override of the SGR formula implementation for 2014, avoiding a 24% cut in physician payments from Medicare.  A longer term fix appears closer than in past years.

http://www.modernhealthcare.com/article/20131218/NEWS/312189951/budget-bill-with-short-term-sgr-fix-clears-congress-ready-for-obama?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGFWdndKRWxiNUtpQzMyWmFwNW5RWUpibWdiUlVxdzBRYzlpS1ZCZjQ5emp5ZHN0bjFRZGU2UmI5WEhxMFIwZXZ3ZUxPbTdkVktKc1dhL0VwL0VlczNoR3dGcGZVelREM3AxUTVlL2x1cUU0bXk2cnVMc0lzPQ==
Dec 10 2013

An AHRQ Statistical Brief shows that for the Medicare population in 2010 the top 5 classes of drug use were metabolic, cardiovascular, CNS, respiratory and gastrointestinal, accounting for $63 billion and 68% of all Medicare drug spending.

http://meps.ahrq.gov/mepsweb/data_files/publications/st411/stat411.shtml
Dec 05 2013

Medicare 2014 Physician Payment Rule

https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-28696.pdf
Nov 29 2013

OIG Strategic Plan 2014

http://oig.hhs.gov/reports-and-publications/strategic-plan/files/OIG-Strategic-Plan-2014-2018.pdf
Nov 29 2013

The HHS Office of Inspector General releases its annual strategic plan, which is must reading for anyone involved with Medicare, Medicaid or other government programs.  EHRs will be a focus of investigations.

http://oig.hhs.gov/reports-and-publications/strategic-plan/files/OIG-Strategic-Plan-2014-2018.pdf
Nov 26 2013

In areas where Medicare Advantage payments are still high, patients can get high-end treatment from specialized clinics, as detailed in a Miami Herald story.  Unfortunately, these clinics may add to the perception that MA plans are overpaid, even though they are doing an outstanding job for patients.

http://www.kaiserhealthnews.org/Stories/2013/November/26/White-Gloved-Medicare-Plans-In-Miami.aspx
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