Category: Medicare and Medicaid, Legislation

CMS ending VBID model due to high costs

The Centers for Medicare and Medicaid Services is terminating the Medicare Advantage Value-Based Insurance Design (VBID) model at the end of 2025 due to what it called the model’s “substantial and unmitigable costs to the Medicare Trust Funds.”

MSSP yielded $2.1 billion in net savings in 2023, CMS says

The Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion in net savings in 2023 – the largest savings in the program’s history, according to the Centers for Medicare and Medicaid Services.

Elevance Health ‘considering options’ following star ratings hit

Elevance Health President and CEO Gail Boudreaux said the insurer is “considering all of our options” regarding the Centers for Medicare and Medicaid Services’ 2025 Medicare Advantage Star Ratings, which saw the company take a hit in its star ratings.

Coverage for weight loss drugs could cost Medicare $35 billion by 2034

If Medicare were to cover anti-obesity medications (AOMs), federal spending would increase about $35 million between 2026 and 2034, finds a new Congressional Budget Office report.

Insurers will make $11.8 billion in Medicare quality bonus payments this year

After increasing by more than 400% between 2015 and 2023, federal spending on Medicare Advantage bonus payments will decline by $1 billion to $11.8 billion in 2024 – an 8% decline – following the expiration of pandemic-era policies that temporarily inc…

Medicare Advantage growth could be challenging for hospitals

The Medicare Advantage program recently achieved the milestone of covering more than half of all Medicare beneficiaries, but according to a report from S&P Global Ratings, this could have an adverse impact on hospital margins.

Consumers more satisfied with Medicare Advantage than commercial plans

Even as the hospitals and health systems continue to battle with Medicare Advantage programs over reimbursement rates, customer satisfaction with MA plans is significantly higher than with commercial member health plans, according to the J.D. Power 202…