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Enrollment in Medicare Advantage (MA) has climbed steadily over the past decade, and of late a key area of focus in this market has been around special needs plans, or SNPs. A new report from KFF finds that these SNPs now account for 21% of all MA enrollees, up from 13% in 2018, the year they became a permanent part of the MA program. Enrollment in SNPs has grown from 2.6 million to 7.3 million in that time frame.
On Jan. 1, CMS will begin implementation of a new alternative payment system for select hospitals. The Transforming Episode Accountability Model will hold participating hospitals responsible for the care quality, costs and post-acute coordination associated with five surgical procedures. The model is intended to mark a shift toward shared accountability and a test of whether healthcare providers can function as “team players” in value-based care.
The average monthly plan premium across all MA plans next year is estimated to fall to $14 from $16.40 in 2025, according to the CMS. Nearly all beneficiaries will have access to an available health plan, and 97% of enrollees will have the choice of 10 or more plans. However, the total number of MA plans nationally will fall from 5,633 in 2025 to approximately 5,600 in 2026.
Allowing Affordable Care Act enhanced premium tax credits to expire at the end of this year would slash $32.1 billion of 2026 revenue from healthcare providers, with a $7.7 billion increase in uncompensated care demand, according to the latest analysis on the highly watched policy issue. The Urban Institute estimate was published Thursday by the Robert Wood Johnson Foundation, which provided funding support for the think tank’s work.
The Joint Commission and the Coalition for Health AI on Sept. 17 issued their first joint guidance on the responsible use of AI in healthcare, outlining principles to help hospitals and health systems adopt the technology safely. The guidance is the first product of a partnership between the two organizations, which was announced in June. It establishes a framework for how healthcare organizations can govern, deploy and monitor AI tools while prioritizing patient safety, data security and transparency.
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