This week we are reading about the oral health of people on Medicare, the deadline for switching or ditching a Medicare Advantage Plan, and Humana expanding its value-based care options for Medicare Advantage.
Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries | Kaiser Family Foundation | March 13, 2019
Medicare, the national health insurance program for about 60 million older adults and younger beneficiaries with disabilities, does not cover routine dental care, and the majority of people on Medicare have no dental coverage at all. Limited or no dental insurance coverage can result in relatively high out-of-pocket costs for some and foregone oral health care for others. This brief reviews the state of oral health for people on Medicare. It describes the consequences of foregoing dental care, current sources of dental coverage, use of dental services, and related out-of-pocket spending.
- Almost two-thirds of Medicare beneficiaries (65%), or nearly 37 million people, do not have dental coverage.
- Almost half of all Medicare beneficiaries did not have a dental visit within the past year (49%), with higher rates among those who are black (71%) or Hispanic (65%), have low incomes (70%), and are living in rural areas (59%), as of 2016.
- Almost one in five Medicare beneficiaries (19%) who used dental services spent more than $1,000 out-of-pocket on dental care in 2016.
Time is Running out to switch or ditch your Medicare Advantage Plan | CNBC | March 14, 2019
Don’t like your Medicare Advantage Plan? You have a couple weeks left to do something about it.
During a window that opened January 1 and will close March 31, enrollees who are unhappy with the choice they made during Medicare’s fall open enrollment period have two options: ditch it for original Medicare or switch to a different plan.
Separately, but also possible until March 31: If you missed your initial Medicare enrollment period and don’t qualify for an exclusion, you can sign up now. In this case, coverage won’t start until July 1.
Humana Expands Value-Based Care Options for Medicare Advantage | Health Payer Intelligence | March 14, 2019
Humana has announced a series of initiatives to increase value-based care for orthopedic services among its Medicare Advantage members.
The organization will partner with orthopedic and neurosurgery practices to launch a new value-based bundled payment initiative specifically designed to provide coordinated care to Humana Medicare Advantage members undergoing spinal fusion surgery.
Called the Spinal Fusion Episode-Based Model (EBM), the initiative offers additional payment to clinicians for improved health outcomes and lower costs across a member’s entire spinal surgery experience. The model will measure improvement on three clinical indication rates, including readmissions, cervical complications, and lumbar complications.