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Medicare Prescription Drug Premiums Projected To Remain Stable

CMS projects that the average premium for a basic Medicare part D prescription drugs coverage plan in 2016 will remain stable, at an estimated $32.50 per month.

This news comes despite the fact that total Part D costs per capita grew by almost 11 percent in 2014, as a result of high cost specialty drugs and their effect on spending in the catastrophic benefit phase.

However, growth in per-Medicare enrollee spending continues to be historically low, averaging 1.3 percent over the last five years. The 2015 Medicare Trustees report projected that the Medicare Trust Fund will remain solvent until 2030, thirteen years longer than they projected in 2009, before the passage of the ACA.

At this time, seniors and people with disabilities are continuing to see savings on out of pocket drugs costs as the ACA closes the “Part D donut hole” over time. More than 9.4 million seniors and people with disabilities have saved over $15 billion on prescription drugs, an average of $1,598 per beneficiary since the implementation of the ACA.

The upcoming annual open enrollment period  begins on October 15 and ends on December 7. It allows people with Medicare to choose health and drugs plans next year by comparing their current coverage and plan quality ratings to other plan offerings. The new benefit choices are effective January 1, 2016.

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CAHPS Hospice Survey Updates

The following information has been posted to the CAHPS Hospice Survey webpage:

URGENT: Access to the CAHPS Hospice Survey Data Warehouse Form is Past Due

The deadline for survey vendors and hospices to submit the 2015 Vendor Access to CAHPS Hospice Survey Data Warehouse Form was July 1, 2015. This form is required in order to obtain user account information and be granted access to the CAHPS Hospice Survey Data Warehouse. If hospices have not yet submitted this form, please do so immediately. Click here to see more information and download the 2015 Vendor Access to CAHPS Hospice Survey Data Warehouse Form.

REMINDER: CAHPS Hospice Survey Quarter 1 2015 Data Submission Deadline Approaching

The deadline for survey vendors to submit CAHPS Hospice Survey Quarter 1 2015 (patient deaths in January 2015, February 2015, and March 2015) data is August 12, 2015. Survey vendors are responsible for successfully submitting files by 11:59 PM Eastern Time on August 12, 2015.

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CMS Releases 2014-2024 Projections of National Health Expenditures

According to a recent report published in Health Affairs authored by CMS’s Office of the Actuary (OACT), total healthcare spending growth is expected to average 5.8 percent in aggregate over 2014-2024. This rate of growth is substantially lower than the 9 percent average rate seen in the three decades before 2008, according to the authors.

Healthcare spending in the United States is projected to have reached $3.1 trillion in 2014, or $9,695 per person, and to have increased by 5.5 percent from the previous year as millions gained health insurance coverage, as well as from new expensive specialty drugs.

Additional findings from the report:

  • Medical price inflation was 1.4 percent. Hospital, and physician and clinical services, which make up the largest portions of medical prices, also increased slowly at a 1.4 and 0.5 percent, respectively.
  • Per-capita premium growth in private health plans is projected to slow to 2.8 percent in 2015 reflecting the expectation of somewhat healthier Marketplace enrollees and the increasing prevalence of high-deductible health plans offered by employers.
  • In 2014, per capita Medicaid spending is projected to have decreased by 0.8 percent as the newly enrolled are expected to be somewhat healthier than those who were enrolled previously.  Overall spending, however, is projected to have increased by 12.0 percent in 2014 as a result of a 12.9-percent increase in enrollment related to the ACA coverage expansion.

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Alzheimer’s Misdiagnoses Significantly Increase Medicare Costs

Recent findings published in the July issue of Alzheimer’s and Dementia found that Medicare beneficiaries who received a misdiagnosis of Alzheimer’s accumulated between $9,500 and $14,000 in additional medical costs each year until they were correctly diagnosed. Researchers concluded that new diagnostic technologies that give earlier, more accurate diagnosis of non-Alzheimer’s related dementias could help patients avoid unnecessary medical procedures and save Medicare money.

Researchers collected data on Medicare enrollment, use of medical resources and associated payments to providers. About 1 in 6 patients studied were incorrectly diagnosed with Alzheimer’s disease before receiving a vascular dementia diagnosis. Approximately 1 in 12 patients studied were also incorrectly diagnosed with Alzheimer’s before being diagnosed for Parkinson’s.

Patients with vascular dementia or Parkinson’s who were misdiagnosed with Alzheimer’s had between 64% and 221% more skilled nursing facility visits, and between 13% and 56% more home healthcare days. Additionally, misdiagnosed patients also had more inpatient days, more ER visits and more physician visits than their correctly diagnosed counterparts.

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Study: Hospice Care Varies From Assisted Living & Home Settings

According to a new study, assisted living residents starting hospice care may be closer to death than people receiving the same care at home. The study, published in the Journal of the American Geriatrics Society, looked at medical data from nonprofit hospice programs across the country. Between 2008 and 2012, researchers found that more than 78,000 patients received hospice care at home, while 7,451 lived in assisted living facilities.

Those individuals receiving hospice care in assisted living facilities were usually older, female and more likely to have dementia. Hospice patients living at home were more like to have cancer.

Additionally, the data showed hospice stays were typically briefer for assisted living residents, lasting no more than 24 days for half of the patients. Home hospice stays typically lasted at least 29 days for patients. Assisted living residents were also about half as likely as home hospice patients to die in a hospital.

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