Medicare

Older adults with behavioral health disorders often experience worse health and functional outcomes, have higher rates of emergency department visits, use more medications, and have higher health care costs than those without a behavioral health disorder. There is need for a greater understanding of the extent to which older adults experience behavioral health disorders.

We evaluated both the Center for Medicare and Medicaid Services Innovation Center (CMS Innovation Center) models and the Medicare Shared Savings Program (MSSP) and found that they have generated gross savings for all beneficiaries in the Traditional Medicare program while demonstrating positive impacts on selected quality measures.

To improve Medicare provider and supplier enrollment data transparency, in 2023, the Centers for Medicare & Medicaid Services publicly released detailed ownership data, including data on change of ownership transactions, for Medicare-enrolled hospices. This brief presents a descriptive analysis of hospice agency changes of ownership nationally between 2018 and 2022.

Between 1988 and 1998, Congress established the Medicare Savings Programs (MSPs). MSPs are Medicaid programs that subsidize the cost of Medicare premiums, deductibles, co-insurance, and other cost sharing for Medicare beneficiaries with low incomes.

Over one million Americans rely on nursing homes for care, yet nursing homes face challenges in recruiting and retaining staff. Nursing homes rely on registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) to provide care, but staff shortages that increased during the COVID-19 pandemic have persisted.

This ASPE issue brief lays out a proposed comprehensive analytic framework to fully evaluate the impact of the CMS Innovation Center’s efforts on the Medicare program and the broader health care system as a whole to test innovative payment and service delivery models that reduce program expenditures while preserving or enhancing the quality of care.

The Centers for Medicare & Medicaid Services (CMS) Innovation Center is in the process of developing the Medicare $2 Drug List (M2DL) Model. This would allow Part D plan sponsors to offer a standardized list of generic drugs for a copayment of $2 or less for a month’s supply that would not be subject to prior authorization, quantity limits, or other utilization management restrictions.

In November 2024, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Program; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly proposed rule.

The purpose of this research was to understand the relationship between state Medicaid payment rates to nursing homes and those facilities’ costs of providing care to Medicaid residents.

This report highlights key programs, activities, and policies of HHS’ strategic approach to addressing social determinants of health, including early accomplishments to date and stories of the on-the-ground impact that these initiatives are making in people’s lives. These and other actions being taken by HHS, and across the federal government, as well as cross-sector initiatives at the com