Blog Archive

For 2026, CMS Finalizes Changes Resulting in a 5.06 Percent Increase in Medicare Advantage Plan Payments and Implements Inflation Reduction Act Provisions on Part D Redesign

On April 7, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Announcement of Methodological Changes for Medicare Advantage (MA) Capitation Rates…

CMS Finalizes CY 2026 Changes to Medicare Advantage and Part D Without Key Provisions Related to Access to Anti-Obesity Medications and Health Equity

On April 4, 2025, the Centers for Medicare & Medicaid Services (CMS) released its Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription…

The History of Reimbursement: The Roots of Medical Insurance

Pricing and payment for medical care in the United States have always been complex, shaped by a patchwork of competing interests, evolving technologies, and shifting policy landscapes. In…

Executing Rapid Summaries of CMS Rules

Each proposed or final rule issued by the Centers for Medicare & Medicaid Services (CMS) carries significant implications for the healthcare sector. A shift in reimbursement methodology or…

How Executive Orders Have Shaped Health IT

When President George W. Bush established the Office of the National Coordinator for Health Information Technology (ONC) within the Department of Health and Human Services by executive order…

Medicare’s Minimum Lifetime Requirement for DME

Meeting clinical need is only part of the equation for manufacturers pursuing Medicare reimbursement for durable medical equipment (DME). To qualify as DME under federal law, a product…

MedPAC Releases March 2025 Report to Congress

Each March, the Medicare Payment Advisory Commission (MedPAC) is required to report to Congress on the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the…

MedPAC Holds March 2025 Meeting

On March 6 and 7, 2025, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: • Reforming Physician Fee Schedule Updates…

The Applied Policy Internship Program

The paradox has become a cliché for aspiring health policy professionals: securing a seat at the table requires experience, but gaining that experience often depends on already having…

MACPAC Holds February 2025 Meeting

On February 27 and 28, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting, which included the following sessions: Hospital Non-DSH Supplemental Payment…

The Growth of Community Health Worker Programs

Although they do not provide clinical care, community health workers (CHWs) can play a critical role in healthcare delivery, particularly in rural and frontier communities. Also known as…

A MedPAC and MACPAC Primer

Applied Policy regularly reports on the meetings and recommendations of the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC). Herein, we…

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