Navigating Through Medicare's Prescription Plan Finder
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The document discusses how baby boomers can save hundreds on prescription drugs through Medicare Part D plans. It explains that over 30 prescription drug plans are offered by Medicare each year, but the author's company focuses on analyzing just the top 10 plans because they are the most cost effective, with prices only increasing for other plans. The document also briefly outlines changes to Medicare Part D coverage gaps due to the Affordable Care Act and trends in Medicare Part D premium costs according to tax returns.
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Medicare reform. The reform of Medicare and the addition of supplemental policies have lengthened the lifespan of the assistance programs, but at the expense of patients and society. Most seniors are on fixed incomes and the cost of supplemental programs impedes their ability to continue their quality of life. Additionally, baby boomers entering this realm will overburden the system, creating larger deficits, and destroying any remaining quality of care that is being provided.
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Medicare is basically broken down into two main categories: the "Original Medicare Plan" and the "Medicare Advantage Plan." Each category is made up of four sub-categories: Part A, Part B, Part C and Part D.
Part A
Part A is hospital insurance provided by Medicare. Most people do not pay a premium for this coverage. Part A covers inpatient care in skilled nursing facilities, critical access hospitals, and hospitals. Hospice and home health ...
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Medicare Spending Report
The document discusses Medicare spending in the United States. It reports that Medicare spending was reduced to 0.2% in 2013 compared to 1.8% between 2009-2012. This decrease may have resulted from the recession limiting spending, delivery system reforms to improve quality while reducing local costs, or a focus on patient-centered care. Statistical data from Medicare budget reports is cited to support the claims around reduced spending.
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This document summarizes a McKinsey report analyzing the unsustainable growth of Medicaid costs in the United States. It finds that by 2009, Medicaid will consume more than 75% of new state revenue in some states and 25-50% in many others. While opportunities exist to capture savings, actually doing so will require difficult decisions and creative leadership given political and structural challenges. Reform is needed to put Medicaid on a more stable long-term footing while still serving those in need.
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This presentation discusses the impact of health reform. It begins by defining the problem, then provides an overview of legislation and the impact on business. It provides a contrarian view of the subject and explains why health reform is really insurance reform. It also introduces the concept of consumer sovereignty,
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Pharmaceutical pricing and reimbursement usa
This document provides an overview of pharmaceutical pricing and reimbursement in the United States. It discusses key demographics and economic factors, the major public and private healthcare programs, and how drug pricing and reimbursement works. The US healthcare system is complex, with prescription drugs constituting 12% of total spending. Major public programs include Medicare, Medicaid, and CHIP, while private sources include employer and individual insurance plans. Pharmaceutical companies set prices freely, while payers determine reimbursement levels and use formularies, tiers, and cost-sharing to manage drug costs.
Chapter 2Where Are WeAmerican health care is in a state of fl
Chapter 2
Where Are We?
American health care is in a state of flux as new scientific knowledge and clinical experience continue to change our definitions of illness and wellness. As a society, we respond by changing the ways health care is delivered. Health services increasingly impact our society—from health status to employment to budgetary economics to recreation to professional concerns to our perceptions of our own well-being.
American health care is also in flux because now that it has grown to more than one-sixth of our economy it threatens to squeeze out public goods such as education and infrastructure maintenance. People have wanted to do something about cost and access to care problems for a long time. The 2010 Affordable Care Act (ACA) is doing much to address access issues, but opposition to certain provisions is strong. Employers are steadily shifting more risk to employees and their families, and there is a real tension between Washington and the state capitols over Medicaid expansion. Medicare trust funds are forecast to disappear over the next decade or so. Washington is unlikely to tolerate another major health reform battle, although major changes may come as a side effect of a “grand” government overhaul of spending and tax policies. The future is highly uncertain, and still we must plan and act as we go along.
This chapter reviews the current status of the U.S. health care system from several points of view:
• Current outcomes and costs
• Quality
• Leadership
• Complexity
• Industrializing structures for delivery
• Medicalization of our society
• Redistribution of wealth
2.1 Current Outcomes and Costs
Previous section
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2.1 CURRENT OUTCOMES AND COSTS
Health care expenditures were projected to rise to close to 20% of the U.S. gross domestic product (GDP) by 2015 (Borger et al., 2006), but more recent estimates from the Centers for Medicare & Medicaid Services (CMS) project it to be 18.2% for 2015 and 19.5% by 2021 (CMS, 2012). Average annual family health insurance premiums were estimated for 2012 at $15,745, with $11,429 paid by employers. The 4% growth rate for 2012 was slow by historical standards but still more than twice the growth rate of wage income. The comparable total insurance cost for a single individual was $5,615. Large employers (98%) offered health care benefits to workers but were cutting back on retiree health benefits. Only 50% of firms with 3 to 9 workers and 73% with 10 to 24 workers offered health benefits. Many small companies do not provide health benefits. At the same time, control of health care by health professionals is being threatened by outsiders calling for more reliance on government programs, more consumer-centered care, or both.
High Comparative Costs and Low Comparative Outcomes
The United States spends far more on health care per capita and as a percentage of GDP than other developed countries, yet does not seem to be much better off for it. Table 2-1 illustrates this ...
Health Care and Medicare Corporate Culture and the Three-Legged Stool
This document discusses the history and current state of Medicare spending in the United States. It notes that while Medicare was originally intended to provide healthcare access for seniors, costs have risen significantly due to an aging population living longer and advancing medical technology. The document analyzes newly released data on payments made to individual physicians by the Centers for Medicare and Medicaid Services to determine if and how healthcare providers may respond to financial incentives.
Implications for The Medicare Program Discussion.docx
This document discusses implications for the Medicare program given demographic trends in the aging US population. It outlines 10 issues arising from an increasing senior population and the implications for Medicare delivery and costs. It also discusses potential solutions to issues providing healthcare for seniors, including maintaining the political and fiscal viability of Medicare in the future.
How doctors could rescue health care by arnold relman | the new york review o...
The document summarizes the challenges facing the US healthcare system, including rapidly rising costs that are unsustainable. It argues that the Affordable Care Act is unlikely to significantly reduce costs due to flaws like not addressing the high overhead of private insurers, fee-for-service payment incentives, and fragmented care. Proposed programs in the Act like Accountable Care Organizations and an Independent Payment Advisory Board face obstacles. Major reforms are still needed to control healthcare spending.
Medicare Reform and Single Payer
This is a training on the financial crisis facing Medicare in the next generation. Are Democratic of Republican proposals for Medicare reform able to address the crisis, or can only single payer save the Medicare entitlement for seniors?
Medicare open enrollment period
The Medicare open enrollment period begins on October 15 and runs through December 7, allowing people with Medicare to change their health and prescription drug plans for the following year. During this period, people can switch to plans that better suit their needs and budget. They can also join a drug plan, switch plans, or drop drug coverage. It's important for people to review their current coverage and consider factors like costs, services covered, and anticipated healthcare needs.
Medicare open enrollment period
The Medicare open enrollment period begins on October 15 and runs through December 7, allowing people with Medicare to change their health and prescription drug plans for the following year. During this period, people can switch to plans that better suit their needs and budget. They can also join a drug plan, switch plans, or drop drug coverage. It's important for people to review their current coverage and consider factors like costs, services covered, and anticipated healthcare needs.
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