Sourcebook

Chapter 2 – Medicare

The federal health insurance program for people age 65 and older and for other adults who qualify due to having a permanent disability or end-stage renal disease.

Modernizing Medicare Part D

During this congressional lunch briefing, analysts will outline the mechanisms of the Medicare Part D program under current law and discuss the potential implications of reforms put forward by Congress and the administration.

Our 2018 Speakers

What’s Next for Medicare Provider Payment?

The goal of this briefing was to provide an update on MACRA implementation, the issues on the table as policymakers consider next steps around shifting the way providers are paid, by both public and private payers, and what this all means for improving health outcomes and quality.

Navigating Next Steps on Payment Reform

This briefing provided an update on the overall state of play with payment reform, and the effort to move away from fee for service and toward value-based payment. Panelists discussed the interplay between the public and private sectors, and, given likely future directions for the CMS Center for Medicare and Medicaid Innovation, highlighted areas where the private sector may be best positioned to lead. Panelists shared what this means for future policy options and needs.

Medicare and Prescription Drug Prices

This briefing featured presentations by our experts highlighting the trends in Medicare regarding prescription drug pricing, and panelists discussed an array of policy options to align drug prices with value through alternative payment models.

High-Need, High-Cost Patients: Challenges & Promising Models

Health systems have applied many innovative new strategies for improving quality and reducing costs when it comes to care for high-need, high-cost patients, who typically have multiple chronic conditions. Which of these innovations show promise, and what can we learn from them?

MACRA: Stakeholder Considerations and Next Steps

The Centers for Medicare & Medicaid Services (CMS) recently closed the public comment period for its proposed rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA). This means that Medicare will soon change its payment system for physicians, and there could be broad implications for physicians, health systems, health plans, consumers and others.

Briefing for Reporters on MACRA & Medicare Payments

The Centers for Medicare & Medicaid Services (CMS) closed on June 27 the public comment period for its proposed rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA). This means that Medicare will soon change its payment system to emphasize value over volume, and physicians caring for Medicare patients will need to make decisions about how to adapt their practices to the new incentives.

Patrick Conway on Medicare Payment Demos

CMS’s Patrick Conway will meet with reporters May 4th to answer questions about recent developments in ACOs, bundled payments and other Medicare payment demonstrations. He’ll also discuss a recently-announced demo, Comprehensive Primary Care Plus, which could bring more flexibility to 20,000 primary care physicians, and may cover services such as telemedicine.

Medicare Payment System Reforms: What Do We Know?

Medicare is testing new ways to pay for medical services, emphasizing value rather than volume, and evidence is beginning to build about successes and challenges. This briefing will examine what we know so far about the basic models, savings, quality, the impact on patients and the prospects for replication.

Medicare Open Enrollment Preview

With Medicare Advantage (Part C) and prescription drug (Part D) open enrollment beginning October 15th, this briefing took a close look at what to expect, including trends in premiums and cost sharing, plan availability and benefit design.

Issues and Future Directions for Medicare

Per capita spending growth in Medicare has slowed over the last few years, although economists disagree about whether that trend will continue. Meanwhile, the number of Medicare beneficiaries continues to increase. Medicare has made systematic changes over the course of its first 50 years, addressing everything from benefits and eligibility to quality of care measurement and provider payment.