Medicare

The Kidney Care National Plan highlights the continued commitment of HHS to advance kidney care and identifies opportunities for policy reform and improvement across the Department’s efforts. The relative lack of innovation in kidney care is the structural outcome of anti-competitive and burdensome actions that have maintained the national crisis of kidney disease and kidney failure.

EXECUTIVE SUMMARYMedicare reimbursement is administered, but it is not insulated from markets for provider labor, capital, facilities, and technology. Traditional Medicare payment formulas incorporate market-basket input prices, geographic wage indexes, case mix, and quality adjustments; total spending also depends on utilization.

KEY POINTS

The overall goal of the project is to expand the utility of National Center for Health Statistics (NCHS) linked data resources to support patient-centered outcomes research (PCOR) through the development of publicly available synthetic linked data files.

Background. Accurately estimating the prevalence of intellectual and developmental disabilities (ID/DD) in the United States remains a challenge, with reported rates varying widely (3%-17%) based on the definitions and data sources used.

Behavioral health (BH) conditions are rising among older adults, who are less likely to receive mental health (MH) or substance use disorder (SUD) treatment compared to younger adults. This study examined the availability of care for older adults in outpatient BH facilities across the United States both quantitatively and qualitatively.

This report examines how integrated care models served full-benefit dually eligible Medicare‑Medicaid beneficiaries in 2021. It compares three types of integrated plans—PACE, FIDE‑SNPs, and D‑SNPs—to standard Medicare Advantage plans, with a focus on hospitalizations, emergency department visits, nursing facility use, home‑ and community‑based services, and mortality.

This study examined how people with Alzheimer’s disease and related dementias (ADRD) use hospice compared with patients who have other terminal diagnoses, as well as how hospice characteristics shape those care patterns.

This Issue Brief explores opportunities that technology-enabled care (TEC) offers to help meet patient and provider needs for high-valued coordinated care to improve health outcomes. It explores literature surrounding existing available TEC options, as well as economic and payment issues that influence whether this is taken up.