Medicare

Two studies published in Cancer reveal that uninsured and Medicaid-insured patients have worse outcomes than patients with private insurance.
In these 2 studies, patients with private insurance had a clear survival advantage
Based on SEER data on glioblastoma multiforme outcomes, researchers found that an uninsured patient was 14% more likely to have a shorter survival time than a patient who carried private insurance.
A patient insured through Medicaid was 10% more likely to have a shorter survival time.
In a study of the outcomes of men diagnosed with testicular cancer, compared with men with private insurance, uninsured men were 88% more likely to die.
Men insured through Medicaid were 51% more likely to die of the disease.

The Meaningful Use program will end in 2016 and will transition to the Medicare and CHIP Reauthorization Act of 2015 (MACRA) and the Merit-Based Incentive Payment System (MIPS) by 2019.
The specifics of the new programs will be revealed in early 2016.
Meaningful Use has successfully resulted in the widespread implementation and use of healthcare information technology (HIT) and systems.
MACRA and MIPS will focus on the use of HIT to improve clinical outcomes and patient experience.

A portion of Medicare recipients could see a significant increase in premiums in 2016.
Premium increases will affect Medicare Part B.
Coincidentally, there will be no Social Security cost of living increase in 2016.
Patients will likely make fewer office visits and will spend less on healthcare.

In 2015, 80% of all Medicare spending will be on new, frequently curative treatments of hepatitis C (HCV) infection.
Medicare spent about $7 million/y on older HCV drugs; will spend about $9 billion on new DAAs in 2015.
Newer HCV drugs will be accompanied by high cost in the first few years of their use. A precipitous drop in spending is expected once the HCV epidemic is stemmed.
HCV-related costs will drop sharply in the coming years, to below $2 billion by 2020, and to just $14 million by 2030.
New DAAs are one of the greatest value propositions in the history of medicine; a fantastic value at a high up-front cost.

Accountable care organizations (ACOs) embody performance-based medicine.
An ACO is a network of healthcare providers and hospitals that shares responsibility for providing all types of healthcare to ≥5000 Medicare beneficiaries at a period of at least three years.
These providers and organizations must be able demonstrate that they can reduce costs while improving outcomes.
Studies have shown that ACOs do effectively achieve these improved results.

Since 2003, legislators in 33 states have passed workers’ comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them.
In 37 states, workers can’t pick their own doctor or are restricted to a list provided by their employers.
For those patients who are able to access workers’ comp benefits, the amounts have been reduced by as much as 65%.

Cost of an orthopedic procedure can vary from $16,000 to $60,000 depending on the geographic location of the surgery.
Per-veteran spending within the VA system ranges from $25,000 per year in Boston to less than $6500 per patient on Cape Cod.
Hospital procedure pricing is seen as largely fictitious and unrelated to actual local financial conditions.
Blue Cross Blue Shield and the Centers for Medicare and Medicaid Services have published tools to help patients learn the cost of a procedure in advance.

Self-perception of young was linked to lower mortality rates among older adults.
Can you teach your patients to feel younger and live longer?
Help your patients feel younger and they’ll live longer.
Teach your patients the value of youthful active.

Twenty percent of surveyed practices reported having been excluded from narrow-network ACA plans in which they would have liked to participate.
The percentage of insurers offering narrow-network plans has increased steadily since 2007.
Insurers use narrow-network plans to increase revenues but docs are blamed by angry patients.

Elderly patients aged 65 to 94 years experienced improved speech perception.
Study included 94 patients, 81% of whom showed improved cognitive abilities following implantation.
Benefits were observable beginning at six months postop.

By 2050, the U.S. will have four times as many people over age 90.
Spending on physicians and outpatient services will rise steadily until patients reach age 83.
Home-health and skilled nursing facility spending will likely increase steadily until patients are in their late 90s.

Obese patients who undergo bariatric surgery are 40% less likely to die at five and 10 years postop.
Bariatric surgery significantly extends the lives of obese patients, even among older men with multiple comorbidities.
Of the 10,000 patients studied, 74% were male and the average body mass index (BMI) among surgical patients was 47 compared to an average of 46 in nonsurgical patients.