Medicare Spending

CMS: Healthcare Spending Accelerated, Reaching $4.5T in 2022

December 14, 2023 - US healthcare spending picked back up last year, reaching a total of $4.5 trillion in 2022, according to the latest numbers from CMS. Healthcare spending growth accelerated, growing by 4.1 percent in 2022, the data published in Health Affairs showed. That is faster than the increase of 3.2 percent in 2022 but significantly slower than the rate of...

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Reducing Barriers to MIPS, Advanced APMs Could Promote Participation

by Victoria Bailey

Reducing barriers to Advanced Alternative Payment Model (APM) participation for physicians in rural areas could help promote value-based care and control rising Medicare spending, according to research...

Physician-Owned Hospitals Could Save Medicare Over $1B

by Jacqueline LaPointe

Physician-owned hospitals treated some of the most expensive Medicare beneficiaries at lower costs compared to traditional hospitals despite seeing similar patient populations, according to a recent...

Lower Payment Rates May Help Curb Medicare Spending on Post-Acute Care

by Victoria Bailey

As Medicare Part A is expected to become insolvent by 2033, Congress should reduce Medicare spending on post-acute care by lowering payment rates to skilled nursing facilities (SNFs), home healthcare...

Healthcare Spending to Pick Up Pace, Reaching $7.2T by 2031

by Jacqueline LaPointe

National healthcare spending slowed during the COVID-19 public health emergency (PHE) as the entire industry experienced severe disruptions to standard care. Now that the PHE has ended, healthcare...

Home Health Value-Based Purchasing Model Lowered Medicare Spending

by Victoria Bailey

The Home Health Value-Based Purchasing (HHVBP) Model reduced Medicare spending by $1.38 billion and improved care quality during its first six years, according to a report from CMS. The CMS Innovation...

Health Disparities in Heart Failure Admissions Cost Over $60M

by Jacqueline LaPointe

Health inequity is costing the Medicare program more than $60 million on preventable heart failure hospital admissions, suggests a new study out of Tulane University. The study published in the most...

Medicare ACO Healthcare Spending Recovered to Pre-Pandemic Levels

by Victoria Bailey

Between 2019 and 2021, healthcare spending by accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) recovered to pre-pandemic levels but shifted from inpatient to...

Biden’s FY24 Budget Aims to Extend Medicare Trust Fund Solvency

by Victoria Bailey

President Biden has announced plans to extend the solvency of the Medicare Trust Fund by at least 25 years in the fiscal year (FY) 2024 budget. The budget includes proposals to stretch the solvency of...

Just A Few Health Systems Dominate Medicare Inpatient Spending

by Jacqueline LaPointe

Medicare inpatient spending is highly concentrated in many parts of the US, causing concerns about the impact hospital consolidation will have on prices in the future. In 10 states plus the District...

Medicare Part B Spending on Laboratory Tests Totaled $9.3B in 2021

by Victoria Bailey

Medicare Part B spending on laboratory tests increased by 17 percent between 2020 and 2021, resulting from high volumes of COVID-19 tests, genetic tests, and chemistry tests, a report from the Office...

National Healthcare Spending Grows 2.7% as COVID-19 Relief Runs Dry

by Jacqueline LaPointe

National healthcare spending is slowing down in the US compared to a significant 10.3 percent increase in 2020. However, healthcare costs remain high as US health expenditures reach $4.3...

Payment Rate Policies Contributed to Lower Medicare Spending Growth

by Victoria Bailey

Changes in Medicare payment policies and varying beneficiary characteristics drove the reduction in Medicare spending growth over the last decade, according to a study published in JAMA Health...

Advanced Bundled Payment Model Reduced Payments for High-Risk Patients

by Victoria Bailey

Hospital participation in Medicare’s Bundled Payment for Care Improvement Advanced Model (BPCI-A) decreased Medicare payments and did not negatively impact health outcomes for high-risk patients,...

Expanding Substance Use Disorder Coverage Would Cost Medicare $362M

by Victoria Bailey

Adding Medicare coverage for substance use disorder (SUD) services for residential programs, intensive outpatient programs, and licensed and certified counselors would cost Medicare $362 million...

Specialty-Oriented ACO Improved Outcomes, Spending for ESRD Patients

by Victoria Bailey

The Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model reduced Medicare payments and hospitalizations among beneficiaries with ESRD, suggesting that specialty-oriented accountable care...

Hospitals Performed 100K Low-Value Procedures During Pandemic

by Victoria Bailey

Hospitals performed more than 100,000 low-value procedures on Medicare beneficiaries in 2020, contributing to the high rate of hospital overuse during the COVID-19 pandemic, according to an analysis...

Collective Reform Program Participation Did Not Improve Health Outcomes

by Victoria Bailey

Collective participation in delivery system and payment reform programs, including accountable care organizations (ACOs), was not generally associated with improved health services outcomes in primary...

COVID-19 Tests Spike Growth in Medicare Spending

by Sarai Rodriguez

COVID-19 tests spiked growth in Medicare spending in 2020. Meanwhile, spending for non-COVID-19 lab tests experienced a decline, according to a report from the HHS Office of the Inspector...

COVID-19 Associated with $13.9B Decline in Medicare Spending

by Sarai Rodriguez

According to a new American Medical Association (AMA) report, utilization of physician services in 2020 declined due to the COVID-19 pandemic, creating a less than expected decline of $13.9 billion in...

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