Last week, the Medicare Rights Center submitted comments to the Center for Medicare & Medicaid Innovation (CMMI) in response to a request for information on a potential new Medicare model. CMMI—an offshoot of the Centers for Medicare & Medicaid Services (CMS), which is the agency that oversees the Medicare program—was created to develop and test new ideas in health care delivery. Most of these ideas involve different ways of paying providers such as doctors or hospitals.

In this request for information, CMMI asked interested parties to provide input on ways to design and test a model for Direct Provider Contracting (DPC). In a DPC model, a beneficiary could choose to join a primary care or specialty provider’s practice and potentially gain certain benefits such as reduced cost sharing or increased services that Medicare does not generally pay for. While this idea may be intriguing, CMMI did not provide any detail on how such a model would work, which leaves some dangerous options on the table.

This week, Avalere Health, a Washington DC-based consulting firm that specializes in strategy, policy, and data analysis, released a study on the impact of moving the coverage of some drugs from Medicare Part B to Part D. While most drugs are covered under the Part D prescription drug program, Part B, the part of the Medicare program that covers outpatient medical services like office visits, covers a few. The drugs covered by Part B are usually ones that beneficiaries would not give to themselves. For example, if a provider administers the drug during an office visit, Part B instead of Part D, might cover that drug.

Earlier this month, the Trump Administration announced it would consider transitioning certain Part B drugs into Part D as part of a larger strategy to lower drug prices and out-of-pocket costs. This makes it essential to understand what effects the switch could have on people with Medicare.

This week, the Centers for Medicare & Medicaid Services (CMS) released new data and a new tool on prescription medication: the Drug Spending Dashboard. The Dashboard allows users to see list prices of various medications, how many manufacturers supply the drug, what they have been paid by Medicare—both Part B and Part D—and Medicaid, total and per beneficiary spending on the drug, and comparisons of spending from 2015 to 2016. Such data show trends in both drug pricing and program spending, and CMS offers additional data for use outside of the Dashboard.

This week, several health care programs appeared in legislation that does not normally address health care. Two of the surprise provisions are embedded in draft Farm Bill legislation and in cuts, or rescissions, requested by the White House. While these measures may gain traction in the U.S. House of Representatives, they face a more uncertain future in the Senate.

This week, the Commonwealth Fund’s Affordable Care Act Tracking Survey showed recent coverage declines among 19-to-64-year-olds. The survey’s focus is on adults who gained coverage through the ACA’s marketplaces and Medicaid.

The findings show that an estimated four million people have lost coverage since 2016. Significant changes can be seen for lower income households and people aged 35-49, and the losses are even more pronounced in states that have not expanded Medicaid—especially southern states—and among people who self-identify as Republican. For example, among Republicans surveyed, the uninsured rate has risen from 7.9% in 2016 to 13.9% in 2018, with self-identified Democrats seeing no change.

This week, the National Council on Aging (NCOA) and the Council for Affordable Health Coverage’s Clear Choices Campaign released a long-anticipated report on the Medicare Plan Finder (MPF) tool. The Modernizing Medicare Plan Finder Report highlights some of the issues Medicare beneficiaries, their families, and their caregivers encounter while using the MPF tool as well as future considerations for the tool’s development and recommendations for improvement.

On January 11, 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance announcing a new policy that, for the first time, will allow states to make participation in a work or “community engagement” program a condition for Medicaid enrollment. The next day, CMS approved a Medicaid waiver in Kentucky that will allow the state to test this new policy.

Over the past few months, the Medicare Rights Center has been actively engaged in considering and commenting on proposals from the Centers for Medicare & Medicaid Services (CMS) that could have significant effects on people who are enrolled in Medicare Advantage (MA) and Part D plans. Last week, CMS released both the Contract Year 2019 Final Rules for Medicare Advantage and Part D (Final Rules) and the 2019 Call Letter. CMS also released fact sheets for the Final Rule and the Call Letter. As we continue to analyze the Final Rules and Call Letter, as well as the impact of the recent two-year budget deal, here is a preview of the issue areas we intend to spotlight, which focus on regulatory trends, anticipated implementations, and practical changes that will impact people with Medicare and those who help them navigate coverage decisions.

Health care in the United States is very expensive, and many experts believe one thing contributing to that expense is the abundance of unnecessary or “low-value” health care services provided to patients. Policymakers typically believe that patients receive this unnecessary care because they expect or demand it. However, this month, the University of Michigan revealed new polling data that turns that assumption upside down.

The Kaiser Family Foundation recently released a report with new data on how much people with Medicare paid for health care in 2016 as a share of their total spending. These data show that Medicare households spend a higher proportion of their incomes on health care coverage, services, and drugs than non-Medicare households. This is important information when discussing what policies should be enacted to protect or improve Medicare’s affordability, especially for those with tight household budgets and fixed incomes.