Medicare touts progress on closing doughnut hole

Nov 7 2011

Meanwhile, MedPAC makes recommendations for controlling costs for "dual eligibles," and Medicare sees new rules bring costs down for weight loss surgery.

The Associated Press: Medicare Prescription Savings Pass $1B Mark
Medicare says seniors with high prescription costs have saved more than $1 billion thanks to the new health care law. President Barack Obama's health care overhaul provides Medicare recipients in the coverage gap called the "doughnut hole" with a 50 percent discount on brand-name drugs this year, and a smaller break on generics. The discounts gradually increase until the coverage gap closes in 2020 (Alonso-Zaldivar, 11/4).

CQ HealthBeat: MedPAC Eyes Recommendations To Streamline Care For 'Duals'
The Medicare Payment Advisory Commission voted this week to send recommendations to Congress aimed at expanding a program that has shown success in better managing the costs of the most expensive part of the Medicare population -; "dual-eligible" enrollees who also qualify for the Medicaid program. Known as PACE -; short for Program of All-Inclusive Care for the Elderly -; the program's premise is that the health care costs of the frail and disabled can best be managed through a comprehensive set of medical, social and rehabilitative services that, in many instances, keep patients out of nursing homes and reduce their visits to hospitals (Reichard, 11/4).

Reuters: Medicare Change Tied To Safer Weight Loss Surgery
After Medicare changed its rules regarding coverage for weight loss surgeries in 2006, the cost for the procedures went down while safety measures increased, according to a new study. Researchers found that the benefits were primarily due to a rules change that allowed Medicare to pay for a newer, less invasive procedure called laparoscopic adjustable banding... Before 2006, Medicare paid roughly $24,000 for each procedure. Afterward, it paid about $20,000 (Grens, 11/4).