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Study Finds Differences in Medicare Advantage Hospitalization Trends

Patients who participate in Medicare Advantage plans spend more time as hospital inpatients but receive less post-acute care than those in traditional Medicare, a new study has found. According to NORC, a non-partisan research organization at the University of Chicago, Medicare Advantage patients had hospital stays that were 40% longer on average than those with Traditional Medicare, which comes to seven days versus five. In 2022, Medicare Advantage plans discharged fewer patients to post-acute care settings such as skilled nursing or home health compared to patients covered by Traditional Medicare. [...]

June 25, 2025|Categories: Medicare, Medicare post-acute care|Tags: Medicare Advantage, Medicare Advantage and inpatient hospitalization, Medicare Advantage and post-acute care|

Federal Health Policy Update for June 19

The following is the latest health policy news from the federal government for June 13-19. Some of the language used below is taken directly from government documents. Congress The Senate Finance Committee The Senate Finance Committee has released its portion of the FY 2025 budget reconciliation bill. Major proposals include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, and new terms under which provider taxes can be approved. New limits on the use of Medicaid [...]

June 19, 2025|Categories: Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|Tags: approved Medicaid state plan amendments, Medicaid cost sharing proposed reimbursement to private health plans for member cost sharing, Medicaid work requirements, Medicare cost report changes, Nursing Home Compare changes, Senate Finance Committee and eligibility redeterminations, Senate Finance Committee and Medicaid cost sharing, Senate Finance Committee and Medicaid provider taxes, Senate Finance Committee and Medicaid state directed payments, Senate Finance Committee and reconciliation bill Medicaid provisions|

Federal Health Policy Update for June 12

The following is the latest health policy news from the federal government for June 6-12. Some of the language used below is taken directly from government documents. Congress Republican senators continue to work on their version of a reconciliation bill with a goal of passage by July 4, although that deadline may slip. Some Senate committees have begun releasing their portions of the bill but the Finance Committee’s bill, with its tax and Medicaid provisions, has not yet been released. Among the majority party in the Senate, fault lines around [...]

June 12, 2025|Categories: Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|Tags: 2026 MACPAC report to Congress, approved Medicaid state plan amendments, approved state directed managed care payment proposals, CDC Advisory Committee for Immunization Practices, Federal Tort Claims Act, FY 2026 budget reconciliation bill, June 2026 MedPAC Report to Congress, Medicaid state directed payments, Medicare Advantage, Medicare ambulatory surgical payment system update, Medicare ICD-10 update, Medicare NCD update, Medicare Part C, Medicare Part D, Medicare Transaction Facilitator, MedPAC comments on proposed FY 2026 Medicare hospice payment system, MedPAC comments on proposed FY 2026 Medicare inpatient prospective payment system, MedPAC comments on proposed FY 2026 Medicare inpatient rehabilitation facilities prospective payment system, MedPAC comments on proposed FY 2026 Medicare skilled nursing facility prospective payment system, OPTN, organ procurement and transplantation network, presidential memorandum eliminating waste fraud and abuse in Medicaid|

HHS Releases Proposed Budget

The Department of Health and Human Services has released a new, expanded version of its proposed FY 2026 budget. In some areas this version provides more detail than the administration shared in early May when it released a so-called “skinny budget” and some aspects of the budget proposal differ from the May release. Highlights of the most recent proposal include: A reduction of 25 percent, from $126 billion to $94.7 billion, in HHS’s overall discretionary (non-mandatory) spending. The consolidation of HHS’s 28 current operating divisions into 15 divisions. A reduction [...]

June 12, 2025|Categories: 340b, Centers for Medicare & Medicaid Services|Tags: 340B, Administration for a Healthy America, Department of Health and Human Services proposed FY 2026 budget, proposed FY 2026 skinny budget|

Administration Targets State Directed Medicaid Payments

The White House has issued a presidential memorandum on “Eliminating Waste, Fraud, and Abuse in Medicaid” that cites Medicaid “state-directed payments” as a form of waste, fraud, and abuse. According to the memorandum, states use state directed payments to pay more than Medicare rates for some Medicaid-covered services – something the memorandum suggests is contrary to current practice because “…billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare.” This assertion comes despite a 2024 regulation that set the payment limit [...]

June 11, 2025|Categories: Medicaid, Medicaid managed care, Medicaid regulations|Tags: Medicaid state directed payments|

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