Medicare

This document provides highlights of the evaluation of the Support and Services at Home (SASH) program for the first years of the program (2010-2016). The SASH program in Vermont is a promising approach to providing support services and care coordination to older adults and individuals with disabilities, using affordable housing properties as a platform for service delivery.

By statute, the majority of patients with end-stage renal disease (ESRD) are eligible for Medicare, regardless of age. Kidney transplantation is ultimately considered the best treatment for ESRD, but ESRD-related eligibility for Medicare coverage extends for only 36 months post-transplant.

Between 1996 and 2013, there was a 54% decrease in the incidence of diabetes-related end-stage renal disease (ESRD-DM) in American Indian and Alaska Native (AI/ AN) populations. This decline has occurred since the Special Diabetes Program for Indians (SDPI) was established in 1997.

Medicare beneficiaries in inpatient psychiatric facilities (IPFs) have complex conditions that require sustained engagement with physical and mental health care providers. People who receive care from IPFs are at risk for a range of negative health outcomes, but surprisingly little is known about their patterns of care.

This study conducted exploratory analyses to develop a better understanding of community-admitted Medicare home health patients, including whether there have been any differential trends between community-admitted and post-acute care (PAC) patients over time and what their patterns of care tell us about the underlying reasons for the community-admitted increased numbers.

The objectives of this research effort were to collect feedback through interviews with physicians in small rural practices on the initial implementation of Medicare’s Quality Payment Program in 2017, a new value-based purchasing program for Medicare physicians.

This study examines hospice ownership in detail by going beyond the general distinction of for-profit or not-for-profit and considers the extent to which regional or national chains have entered the hospice provider market and how the populations they care for and the services they provide might be distinct from other types of hospice agencies.

The prices charged by drug manufacturers to wholesalers and distributors (commonly referred to as exmanufacturers prices) in the United States are 1.8 times higher than in other countries for the top drugs by total expenditures separately paid under Medicare Part B. U.S. prices were higher for most of the drugs included in the analysis, and U.S.

Medicare Advantage (MA) plans that serve relatively higher proportions of dually enrolled beneficiaries have lower ratings in the MA Star Rating program than plans that serve fewer dually enrolled beneficiaries. However, some MA plans that serve a high proportion of dually enrolled beneficiaries are high performers.

The Centers for Medicare and Medicaid Services (CMS) uses the Star Rating program to measure the quality of Medicare Advantage (MA) plans, publicly report plan performance, and determine quality bonus payments and rebates for MA plans.