Latest Morning Briefing Stories

Betting On Medicare Advantage Pays Off Big For UnitedHealth

KHN Morning Briefing

UnitedHealth executives said they added 370,000 Advantage members during the open enrollment period that ended Dec. 7, which reflects growth of about 140% over the prior annual enrollment period. As the program grows in popularity, insurers clamor for a piece of the lucrative marketplace.

Bundled Payments Fall Short Of Expectations In Cutting Spending, Improving Quality

KHN Morning Briefing

The federal government, hospitals and physicians have been gravitating toward bundled payments, but new studies challenge the belief that they help achieve cost savings. Meanwhile, CMS is proposing changes to Medicare Advantage payments for 2021, including an increase in the percentage of patient “encounter data” used to calculate payments.

HHS Taps Entrepreneur Brad Smith To Lead CMS Innovation Center

KHN Morning Briefing

The position leading the agency’s Center for Medicare and Medicaid Innovation largely focuses on driving value-based care transformation across the country, Brad Smith says. CMS Administrator Seema Verma praised Smith as an “outside-the-box” thinker who will “help us build on the important work the Trump administration has undertaken to transform our healthcare system to deliver better value to patients.”

Inspector General’s Report Raises Red Flags Over Billions In Medicare Advantage Payments To Private Insurers

KHN Morning Briefing

An Inspector General report suggests that private insurers are combing through patients’ files and adding on conditions like diabetes to make the patient looks sicker than they were to get more money from the government. A spokeswoman for America’s Health Insurance Plans said the report is based on a type of data with well-documented challenges, and noted that the watchdog didn’t review medical records for the analysis.

Dems’ Drug Pricing Bill May Be Destined For Eventual Death In Senate, But Its Political Life Is Only Just Beginning

KHN Morning Briefing

It’s likely that Democrats are viewing House Speaker Nancy Pelosi’s drug pricing bill as a political tool rather than a realistic goal. The legislation is already being used in ads for vulnerable Democrats and candidates are planning to tout it as a main component of their health care agendas. “Republicans will spend the next year defending their decision to block Medicare from lowering prescription drug prices for everyone,” said Jesse Ferguson, a veteran Democratic messaging consultant. After Pelosi secured a deal with the progressive wing of her party, the House is set to vote on the bill on Thursday.

Medicare Advisory Commission Deems Payments To Ambulatory Surgical Centers As Already High Enough

KHN Morning Briefing

Eliminating the increase would produce cost savings for Medicare without hurting access to care or the willingness of ambulatory surgical centers to deliver services to Medicare beneficiaries, the Medicare Payment Advisory Commission ruled. In other news, Saturday is the deadline for Medicare enrollment, but some advocates are calling for flexibility because of the difficulties some beneficiaries have encountered while trying to sign up.

Increasingly Bitter Personal Rivalry Between Azar And Verma Threatens To Derail Administration’s Health Goals

KHN Morning Briefing

Politico reports on the escalating feud between HHS Secretary Alex Azar and CMS Administrator Seema Verma and the disruptions people close to the situation say it has caused. Privately, Azar’s and Verma’s camps are pointing the finger at one another, and disclosures about Verma’s use of highly paid consultants to raise her personal profile exacerbated the tensions.