Medicare beneficiaries

This brief highlights key provisions of the federal Inflation Reduction Act of 2022, recently signed into law by President Biden. The law includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government, beginning in 2023. This brief examines the potential impact of these provisions for Medicare beneficiaries nationally and by state.

On Monday, June 27, 2022 the Biden Administration announced a new model aimed at improving cancer care for Medicare patients and lowering health care costs. CMS’ Center for Medicare and Medicaid Innovation designed the Enhancing Oncology Model (EOM) to test how to improve health care providers’ ability to deliver patient-centered care and consider patients’ unique needs. The model will focus on supporting patients, caregivers, and survivors, while addressing inequities and providing patients with treatments that address their individual needs.

JAMA researchers found lower service use and lower Medicaid spending among the Black population for both during a review of health care spending statistics between White and Black Medicaid enrollees. Medicaid beneficiaries make up a diverse population, yet existing disparities persist. To explore differences in Medicaid spending between Black and White populations, researchers conducted a cross-sectional study using data from three states in 2016. Researchers used data from 1,966,689 enrollees in the study, including both adults and children. Of this population, 867,183 identified as non-Hispanic Black, and 1,099,506 identified as non-Hispanic White.

This Policy Spotlight describes Medicare’s Wellness Visits, current approaches to provide this benefit to Medicare beneficiaries, challenges related to access, and opportunities for the Aging Network. This brief also presents policy and programmatic recommendations to improve the effectiveness of Wellness Visits.

The Biden-Harris Administration has announced that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to eight tests per month from participating pharmacies and health care providers for the duration of the COVID-19 pandemic.

The Administration's new COVID-19 testing initative will now allow people in either Original Medicare or Medicare Advantage to get up to eight over-the-counter COVID-19 tests per month at no cost starting this spring. Tests will be available through eligible pharmacies and other participating entities. This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries. Through the new initiative, payment from Medicare will be provided directly to participating pharmacies to allow Medicare beneficiaries to pick up tests at no cost.

The CMS Office of Minority Health (OMH) has published a new report, Trends in Racial, Ethnic, Sex, and Rural-Urban Inequities in Health Care in Medicare Advantage: 2009-2018. Since 2015, CMS OMH has published annual reports highlighting inequities in the quality of care delivered to Medicare beneficiaries nationwide. Until now, these reports have focused on comparisons within a single year. This new report analyzes historical trends in inequities by race, ethnicity, sex, and geography among Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide.

CMS is expanding opportunities for people to receive COVID-19 vaccinations in their home to ensure that Medicare beneficiaries who are hard-to-reach can receive the vaccination. Healthcare providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home.