Medicare

This report describes validation of claims-based frailty algorithms for potential use in Medicare claims. Related Products:

RAND identified use cases on identifying frailty using electronic health record (EHR) data in health systems in the US and examples from other countries, which demonstrate applications in both primary and specialist care. The final EHR implementation guide summarizes the learnings from participants in the EHR Learning Network and the identified use cases.

The Inflation Reduction Act (IRA) is helping people with Medicare afford their medications, including the 2.1 million Asian, 5.8 million Black, and 5.3 million Latino Part D enrollees. These fact sheets review existing research to present the projected impacts of key IRA Medicare drug-related provisions for these populations.

The Inflation Reduction Act (IRA) authorizes the Secretary of the Department of Health and Human Services (HHS) to negotiate prices directly with participating manufacturers for selected drugs that are high expenditure, single source drugs without generic or biosimilar competition.

Introduction

To enhance transparency in health care markets, in December 2022, the Centers for Medicare & Medicaid Services (CMS) publicly released comprehensive data on the ownership of all U.S. hospitals that are enrolled in Medicare. This report provides an overview of the available data, a methodology for assigning hospitals to chains, and several preliminary analyses to showcase the data.

This research report updates prior reports on Medicare FFS telehealth trends during the COVID-19 public health emergency with data through end of 2021, by beneficiary characteristics, visit specialty and geography including by state. Medicare telehealth flexibilities during the COVID-19 pandemic continued to encourage use of telehealth among Medicare beneficiaries in 2021.

Enrollment in Medicare Advantage plans has increased rapidly in recent years. The share of eligible Medicare beneficiaries enrolled in MA rose from 25% in 2010 to 47% in 2021 (27.6 million enrollees). Payments to MA plans more than doubled between 2015 and 2021 (from $175 to $361 billion), taking the share of total Medicare Parts A & B spending on MA from 38% to 54%.

Understanding Coverage Considerations for COVID-19 Vaccines and Treatments (Updated May 2023)

Effective January 1, 2023, out-of-pocket costs for insulin are capped at $35 per monthly prescription among Medicare Part D enrollees under the Inflation Reduction Act (IRA). A similar cap takes effect in Medicare Part B on July 1, 2023.