Fact Sheets

HHS recently announced the ‘HHS Bridge Access Program For COVID-19 Vaccines and Treatments Program’ creating a $1.1 billion public-private partnership to help maintain uninsured individuals’ access to COVID-19 care at their local pharmacies, through existing public health infrastructure, and at their local health centers. Centers for Disease Control and Prevention (CDC) will purchase and distribute COVID-19 vaccines to 64 state and local health department immunization awardees, and the awardees will distribute vaccines to local health departments and health centers supported by the federal Health Resources and Services Administration (HRSA). Second, create is creating a novel, funded partnership with pharmacy chains.

On Friday, April 28th, CMS released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of January 2023, over 65.5 million people are enrolled in Medicare; more than 33.9 million are enrolled in fee-for-service Medicare and nearly 31.6 have a Medicare Advantage plan. Over 93 million enrollees have Medicaid and CHIP; more than 85.9 million individuals have Medicaid and nearly 7.1 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

CMS issued the fiscal year (FY) 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system Reporting (IQR) program and are meaningful electronic health record (EHR) users is projected to be 2.8% for FY 2024. Hospitals may be subject to payment adjustments under the IPPS. The proposed increase in operating and capital IPPS payment rates will generally increase hospital payments in FY 2024 by $3.3 billion.

The Nutrition and Aging Resource Center has created this resource to support Title IIIC meal programs navigating the expiration of the Public Health Emergency (PHE). The factsheet reviews what nutrition programs should expect as well as recommendations on how to meet requirements as flexibilities related to the PHE end.

CMS issued a proposed rule (CMS-1787-P) that would update Medicare hospice payments and the aggregate cap amount for FY 2024 in accordance with existing statutory and regulatory requirements. This rule includes information on hospice utilization trends and solicits comments regarding information related to the provision of higher levels of hospice care, spending patterns for non-hospice services provided during the election of the hospice benefit, ownership transparency, equipping patients and caregivers with information to inform hospice election decision-making selection, and ways to examine health equity under the hospice benefit. This rule also proposes conforming regulations text changes related to the expiration of the COVID-19 PHE.

On Wednesday, April 5th, CMS issued a final rule that revises the Medicare Advantage (MA or Part C), Medicare Prescription Drug Benefit (Part D), Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, and network adequacy. Additionally, the final rule also makes permanent the Limited Income Newly Eligible Transition (LI NET) Program and expands eligibility for the full low-income subsidy benefit to individuals with incomes up to 150% of the federal poverty level who meet eligibility criteria.

CMS released the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the Rate Announcement). CMS will phase-in certain updates, and on average, CMS anticipates a payment increase for MA plans of 3.32% from 2023 to 2024, which is approximately a $13.8 billion increase in MA payments for next year. The Rate Announcement finalizes updates to MA payment growth rates and changes to the MA and Part D payment methodologies. These include technical and clinical updates to the MA risk adjustment model to keep it up to date and improve payment accuracy.

2023 Alzheimer’s Disease Facts and Figures is a statistical resource for U.S. data related to Alzheimer’s disease, the most common cause of dementia. Background and context for interpretation of the data are contained in the Overview. Additional sections address prevalence, mortality and morbidity, caregiving, the dementia care workforce, and the use and costs of health care and services. The Special Report examines obstacles and opportunities for achieving better care in an era of new treatments for Alzheimer’s.

AARP’s Public Policy Institute released a report titled “Underused Medicare Savings Programs Can Help Many More Older Adults Afford Health Care”. Medicare Savings Programs or MSPs provide financial assistance with certain Medicare costs for eligible low-income Medicare beneficiaries, and are administered by state Medicaid agencies. According to the report, about 16 percent of all Medicare beneficiaries are enrolled in MSPs; however, the number of individuals eligible for these programs is estimated to be much higher. The paper discusses the findings from the organization’s analysis and research, and proposes areas states can consider to increase enrollment and expand eligibility.

Resources for Integrated Care (RIC) recently released a brief on telehealth, and its impact on dually eligible people with intellectual and developmental disabilities (I/DD). As noted by RIC, people dually eligible for Medicare and Medicaid, as well as people with I/DD, are diagnosed with multiple chronic conditions at higher rates than the general population and often face barriers with access to healthcare. Telehealth services have been increasing in popularity and usage and has the potential to positively impact people with I/DD. Health plans can utilize the information in the document to further their understanding of how telehealth modalities can improve access to person centered care for people with I/DD.