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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Jun 9 2023

Full Issue

CMS Will Test Out Value-Based Model For Primary Care

The Centers for Medicare & Medicaid Services announced that it will test a new primary care model in eight states for a 10-year period. The experiment will weigh the concept of paying Medicare and Medicaid providers for the value of services, rather than the volume.

The Biden administration on Thursday announced a 10-year experiment aimed at improving the way Medicare and Medicaid pay for primary care. The effort, dubbed the Making Care Primary Model, will ease safety-net and independent primary care providers 鈥 including federally qualified health centers 鈥 into getting paid for the value of services they provide, rather than the volume. (Goldman, 6/9)

In collaboration with state Medicaid agencies, CMS plans to run this pilot program in Colorado, Massachusetts, Minnesota, New Jersey, New York, North Carolina and Washington state through 2034. Applications will be available in late summer 2023, the agency said. (Turner, 6/8)

In other news about Medicare and Medicaid 鈥

A top Senate Republican signaled his interest in pursuing hospital payment reform to ensure Medicare is paying the same price for services, regardless of where they are provided. The comments are one of the first indications that House Republicans鈥 interest in reforming hospital payments could have any momentum in the upper chamber. (Cohrs, 6/8)

You鈥檝e seen the headlines. The United States Postal Service (USPS) has been losing money. (A recent USPS press release said it鈥檚 already lost $2.1 billion this year.) So, Congress passed the Postal Service Reform Act of 2022 (PSRA). ... Starting January 1, 2025, PSHB plans will replace FEHB plans for Postal Service retirees and, to qualify, they must enroll in Medicare Part B. (Omdahl, 6/6)

吃瓜不打烊: Debt Deal Leaves Health Programs (Mostly) Intact

The bipartisan deal to extend the U.S. government鈥檚 borrowing authority includes future cuts to federal health agencies, but they are smaller than many expected and do not touch Medicare and Medicaid. Meanwhile, Merck & Co. becomes the first drugmaker to sue Medicare officials over the federal health insurance program鈥檚 new authority to negotiate drug prices. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Lauren Weber of The Washington Post, and Jessie Hellmann of CQ Roll Call join 吃瓜不打烊鈥 chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews 吃瓜不打烊 senior correspondent Sarah Jane Tribble, who reported the latest 吃瓜不打烊-NPR 鈥淏ill of the Month鈥 feature, about the perils of visiting the U.S. with European health insurance. (6/7)

吃瓜不打烊: Dental Therapists Help Patients In Need Of Care Avoid The Brush-Off聽

All six of Michelle Ehlert鈥檚 children have Medicaid plans that should cover their dental care. But for years, she and her husband paid for dental care out-of-pocket 鈥 sometimes thousands of dollars a year. They couldn鈥檛 find a dentist near their home in Wilkin County, Minnesota, who accepted Medicaid. When a mobile clinic that would treat Medicaid patients drove nearly 200 miles from Minneapolis to the rural county on Minnesota鈥檚 western border, appointments that fit her family鈥檚 schedule were 鈥渉it-or-miss,鈥 she said. (Saint Louis, 6/9)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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