Updating Medicare’s physician fees is a challenge again
James C. Capretta | Jul 27, 2022 | Federal
Congress and the Centers for Medicare and Medicaid Services (CMS) have struggled for three decades to establish a stable, and affordable, system of determining annual updates for physician fees. While it was hoped that a law passed in the middle of the last decade would permanently end the volatility, it
Medicare projections from CBO and the program’s trustees
James C. Capretta | Jun 14, 2022 | Federal
The Congressional Budget Office (CBO) and the board of trustees charged with overseeing Medicare’s financial health recently released updated forecasts of the program within days of each other. These latest reports are valuable starting points for examining Medicare’s current status and likely future course. CBO’s Medicare estimates, released
Standardized plan requirements for ACA coverage in 2023
James C. Capretta | May 17, 2022 | Federal
On April 28th, the Centers for Medicare and Medicaid Services (CMS) announced its final Affordable Care Act (ACA) rule adjustments for calendar year 2023. Among the changes is a requirement that plan sponsors participating in the federally run exchange--healthcare.gov--offer standardized plans in addition to their other products. An important aim
Medicare and inflation
James C. Capretta | Apr 18, 2022 | Federal
The most recent consumer price index (CPI) release from the Bureau of Labor Statistics (BLS) revealed that the rate of annual inflation from March 2021 to March 2022 was 8.5 percent -- the highest in four decades. If such rapid price escalation persists for an extended period, it will have
Implications of the President’s 2023 budget for health care
James C. Capretta | Mar 29, 2022 | Federal
The Biden administration unveiled its updated budget plan this week, and it includes both new policies affecting health care and a re-commitment to previously-advanced initiatives. The release, which the president is required by law to send to Congress annually, covers the fiscal year 2023 (which starts on October 1 of
The status of Public Health Emergency declarations
James C. Capretta | Mar 16, 2022 | Federal
While the future course of the COVID-19 pandemic remains uncertain, federal and state officials are considering when, and how, to unwind the remaining emergency measures taken during the initial weeks of the crisis. The following is an overview of the authorities that were invoked and the issues raised by plans
Background on CMMI’s Direct Contracting Model
James C. Capretta | Feb 18, 2022 | Federal
The Biden administration has come under pressure in recent weeks to modify, or even pull back entirely, the Center for Medicare and Medicaid Innovation’s Direct Contracting Model, which was originally developed during the Trump era. (The administration has indicated it will announce its plans for the model “soon”.) The following
The CMS-Georgia waiver battle
James C. Capretta | Jan 28, 2022 | Federal
Georgia Gov. Brian Kemp has been engaged in a multi-year back-and-forth with federal officials over the state’s Medicaid and insurance market waiver programs, as reflected in the following timeline of the most notable steps taken by both sides. A final resolution of the standoff is not yet in sight, or
Vaccine efficacy (Part II) and Delta hits close to home
Jonathan King | Aug 13, 2021 | Alaska
Since April 2020, Anchorage-based economist and leadership coach Jonathan King has written a weekly email to clients and friends digesting Alaska’s most recent COVID data and bringing to light relevant information he thinks will benefit his stakeholders. This week he shared his thoughts on the challenges of calculating, and communicating
Colorado’s standardized health benefit plan (HB21-1232)
James C. Capretta | Aug 2, 2021 | Colorado
Elected officials in Colorado have made their state the third to adopt legislation mandating tightly-regulated health insurance offerings. As was the case in Washington and Nevada, the push came from advocates of a “public option,” although the final bill (HB21-1232) leverages private coverage, not public insurance. None of the three
