Medicare beneficiaries

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.

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.

Prior work has shown that home health providers strategically provided therapy visits and recertified episodes in order to maximize payment under traditional Medicare (TM). However, Medicare Advantage (MA) has more flexibility in terms of how they pay for home health care. This mixed-methods study examines changes in patterns of post-acute and community-admitted home health care use between 2011 and 2016, focusing on differences between MA and TM and across MA contract types.