Tag Archives: Medicare

Medicare is almost $200 billion in gross drug spend: Who gets the blame? — 46brooklyn Research This is a complex issue as there are many moving parts to drug pricing and their costs. Perplexing in describing the drug spend issues would seem appropriate. I am not even sure if this long post will adequately define the issue of how drug prices are set. However, here is another article which I believe may break this down even more so. Later on...

A good article on hospital increasing healthcare costs, due to consolidations, supplies, and the associated hospital operational management. The article also engages in a book review of Big Med by David Dranove and Lawton Robert Burns (“Megaproviders and the High Cost of Health Care in America“). I will have to check the book out and advise later. Towards the end of the article, Shannon has included elements of Single Payer in her review-critique...

Introduction: FFS Medicare Overhead costs are ~2%. Medicare Advantage overhead costs are far higher. The same can be said for commercial healthcare costs paid by insurance companies. Neither MA administered healthcare or commercial insurance plans can compete with FFS Medicare for costs and care. I will touch on a few reasons why on Medicare at the end of this article which came by way of Dale Coberly, the resident expert of today’s SS. As...

Introduction: Before I get started on the main text of Kip’s expert article, I wish to point out something which is happening nationally. There is a plan afoot of forcing people into Value-Based Payment plans from traditional Medicare. The players include Iora Health (subsidiary of One Medical), Privia, General Catalyst, agilon health, Caravan Health, Signify (CVS owned), Village MD (Walgreens owned), Premier, etc. This is being done in...

This was sent to me by Dale Coberly. I was wondering why Dale was sending me trash advertisements. Skimmed it and then it dawned on me. Much of this advertising is made to sway people’s minds to do something. It is the type of advertising I sometimes wish to throw a shoe at the 65-inch screen when it should be shown on a 12 -inch screen. It is especially aggravating, when the advertising includes the famous, the rich, the good-looking, etc....

JAMA Network “How Do Commercial Insurance Plans Fare Under Proposed Prescription Drug Price Regulation?” Rena M. Conti, Richard G. Frank, Len M. Nichols December 2021, this article came out detailing Medicare negotiating directly with pharmaceutical companies and the impact of the negotiation on people insured by commercial plans. That is if commercial insurance plans were included in the price reductions given to Medicare. We are going to see how...

This is an interesting result I ran across in MSN as taken from Reuters. Both Kip Sullivan and I have written about Medicare Advantage plans over coding patients, resulting in overcharges to CMS Medicare. “Why is CMS Overpaying United Healthcare Medicare Advantage Plans?” – Angry Bear, “Medicare Advantage and Medicare Issues” – Angry Bear, “Kip Sullivan and Ralph Nader Talk Tradition Medicare vs Medicare Advantage” – Angry Bear, etc. Advantage Plans...

As is typical, Charles Gaba at ACA Signups.net has the answers to the question. Charles does a lot more of this type of analysis such as the Healthcare’s Three – Legged Stool, ACA Enrollment, Risk Pools, etc. All three of these are at Angry Bear. I am not sure why Michigan state and federal legislators are not knocking on his door for direction on healthcare. By that comment, I am not talking about commercial insurance exclusively. Ok, the...

Andrew writes on healthcare, mostly the PPACA plan and the various metal plans, and the latest gig (ARPA) resulting in lower costs for anyone under 250% FPL and lower costs for anyone higher than 400% FPL. All made possible due to Biden and Democrat’s American Rescue Plan Act of 2021. It will expire EOY 2022 and I doubt Manchin will help with it. Without it and other aid, This all could have been a 2008 Redux. Mostly, what you will catch me...

Copy and Paste for now until I can get into the Health Affairs article. Hospitalization averages a third of all healthcare costs. The pricing (Pricing equals costs in this instance) varies by region which kind of tells me there “may” be variation due to the strength of ACOs in regions. Trends in Hospital Prices Varied Widely Across the United States | RAND The average prices charged to commercial health plans by hospitals, as compared to what...