Medicare

The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.

Latest Resources

• Provisions Of The Inflation Reduction Act Likely To Destabilize Long-Term Care Pharmacies
• New CMS LEAD Model Aims To Expand Access To Accountable Care, Improve Health Outcomes
• 16% Of Nursing Home Residents Spend Down Savings To Qualify For Medicaid
• FDA Seeks Statements Of Interest For TEMPO Digital Health Devices Pilot For Those With Chronic Disease
• Medicare Advantage Beneficiaries With Mental Health Diagnoses Made More Mental Health Visits After Switching To Traditional Medicare
• Feds End Minimum Staffing Rule For Nursing Services For Long-Term Care Facilities
• Medicare & Medicaid Programs; Repeal Of Minimum Staffing Standards For Long-Term Care Facilities
• Medicare Chronic Care Management Model To Test Technology-Supported Care Plus Outcomes-Aligned Payments
• CMS Seeks Five More State Medicaid Agencies To Participate In The Innovation In Behavioral Health Model
• CMS To Implement Mandatory Medicare FFS TEAM Model To Provide Bundled Payments For Five Common Surgical Procedures
• All 50 States Seek To Transform Rural Health With CMS
• Medicare Part B Premiums Will Increase By $17.90 In 2026
• Medicare Updates Processing Of Telehealth Claims, Will Allow Provider Organizations To Resubmit Some FFS Telehealth Claims
• Medicare Finalizes Behavioral Health Integration Add-On Codes For Advanced Primary Care Management
• Medicare Diabetes Prevention Program To Offer On-Demand Access

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Medicare Advantage Beneficiaries With Mental Health Diagnoses Made More Mental Health Visits After Switching To Traditional Medicare

Among Medicare beneficiaries with mental health diagnoses, those who switched from Medicare Advantage to traditional Medicare in 2018 made more mental health visits after the switch, according to a recent study. Researchers conducted a longitudinal analysis of Medicare Advantage encounter data and traditional Medicare claims data from 2017 and 2018 for beneficiaries diagnosed with mental health disorders. The comparison focused on mental health utilization for the 12 months before and after beneficiaries switched from Medicare… Read

• Nearly Two Thirds Of Nursing Homes That Graduated From The Federal Program To Improve Nursing Home Quality Were Unable To Sustain Performance
• Medicare To Implement The New Ambulatory Specialty Model For Beneficiaries With Heart Failure & Those With Low Back Pain
• Final Medicare Physician Fee Schedule For 2026 Includes Policies To Address Undervaluation Of Time-Intensive Services
• Vermont, Utah & Minnesota Are Top-Ranked States For Medicare Beneficiary Access To High Quality, Affordable Care
• Medicare Coverage Of Digital Mental Health Treatment Devices To Include ADHD

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