Large hospital systems often complain about Medicare Advantage (MA) plans. Just last year some large hospital systems reported dropping or threatened to drop major MA plans run by health insurers. One complaint is low reimbursement, but arguably a more irritating business practices by MA plans is excessive prior authorization and slow payments. Breaking up with an MA plan runs the risk of shutting out thousands of potential patients. A strategy more large hospital systems are exploring is establishing their own MA plans.
Category: Medicare
Saturday Links – 24 January 2026
- A Trump trade deal that is good for the US and the UK.
- There is supposed to be a $2,000 cap on Medicare enrollee drug spending. So how do some people reach the cap after spending only $1,200?
- How to reform the food stamp program.
- Kotlikoff on entitlement programs:
Earn or save $1 too much and, depending on the state, lose thousands of dollars in your own or your family members’ Medicaid benefits. Hold $1 too much in assets and forfeit thousands in Supplemental Security Income (SSI). Earn an extra dollar in a Medicaid non-expansion state and receive thousands of dollars in otherwise unavailable [Obamacare] subsidies.
In 2023, a record 62 million Americans smoked pot; 17 million now use it daily or near daily. One in 12 young adults used a hallucinogen; one in 18 misused prescription stimulants such as Adderall. Another 2.6 million Americans over 12 took meth. Overdoses still claim the lives of 70,000 Americans annually; the majority died using synthetic opioids like fentanyl. HT: Arnold Kling
Congress Should Not Force Medicare to Reimburse New Technology without Evidence of Value
For the past several years Congress has been debating a version of Ensuring Patient Access to Critical Breakthrough Products Act. The goal is to force Medicare to reimburse new medical device products that the U.S. Food and Drug Administration (FDA) claims are breakthrough devices, without letting Medicare determine whether these new devices have any value.
Saturday Links
- More on the inverted food pyramid.
- RFK Jr. On Trump’s Diet: “I Don’t Know How He’s Alive.”
- Cato on Reconciliation 2.0: How to cut Obamacare and Medicare spending.
- Medicare Actuary’s Office: spending on (Obamacare) Exchange subsidies rose by a whopping 34.9 percent in 2024—this after 25.5 percent growth in 2023.
- Trump: The Great Health Care Plan
- The main driver of increased health care spending is greater volume and intensity of care, not higher prices.