CMS Promotes Value for Seniors and Persons with Disabilities in Medicare Plans

By Jonathan Blum, Acting Principal Deputy Administrator and Director, Center for Medicare

With today’s regulation limiting overhead and profits for Medicare Advantage and prescription drug plans, the Affordable Care Act continues to promote value for consumers’ and taxpayers’ health care spending. These new requirements apply to Medicare health and drug plans offered by private insurance companies serving over 37 million seniors and persons with disabilities, and build on a similar regulation we issued last year requiring a minimum medical loss ratio for health plans serving consumers in the private insurance market. Medicare health and drug plans, beginning next year, must meet a minimum medical loss ratio, limiting their spending on non-health related items such as administrative costs, profit, or overhead. More specifically, this means that the plans must spend at least 85 percent of their revenue on direct benefits to Medicare enrollees such as clinical services, prescription drugs and quality improving activities.

The new Medicare MLR requirements will also give people with Medicare and their caregivers more information about Medicare plans when comparing their health care options during enrollment periods. They will be able to consider a plan’s medical loss ratio, along with quality ratings, coverage, premiums and other factors that influence their health care decisions.

Administration announces $1 billion initiative to provide better health care and lower costs

By Rick Gilfillan, Director, CMS Innovation Center

Bringing down health care costs is a top priority. That’s why the Affordable Care Act contained an historic set of reforms designed to reward higher quality and lower the cost of care.  And we know that the best way to do that is the same way leading health care organizations do it: by making care better and more efficient.

We also know there are great ideas out there that can help push this work forward and that the kinds of innovative practices that make our health care system work better for everybody can come from any corner of the country. That’s why today we’re launching a $1 billion initiative through a second round of Health Care Innovation Awards.

These Innovation Awards will be given to organizations whose creative solutions to our most pressing health care challenges have the potential to serve as models for improving care and lowering costs across the country.

In November of 2011, we launched our first round of Health Care Innovation Awards by issuing a challenge to America’s health care providers, businesses, universities, and community groups.  We asked them to submit their proposals for how to get the most out of our health care dollars by delivering better care. That challenge resulted in more than 3,000 applications, from which a team of independent experts and HHS officials selected 107 promising innovations with the strongest likelihood of creating larger-scale, sustainable results.

Older Americans Month 2013: Unleash the Power of Age!

For 50 years, May has been the month we celebrate older adults across the nation. You could say that Older Americans Month is coming of age. This year’s theme—“Unleash the Power of Age!”—emphasizes older Americans’ potential for energy and activism and urges them to embrace it.

There’s no age limit on achievement—and older Americans are doing incredible things. They make a difference in their communities by continuing their careers, pursuing new business ventures, and volunteering in their retirement years.  To find ways to get involved in your community, visit Serve.gov.

Staying active, engaged, and healthy is good advice for everyone, but it’s especially important for older people. The U.S Administration on Aging (AoA), supports older adults through programs and resources to encourage healthy living. In addition, the Affordable Care Act is making certain vital preventive services, such as mammograms, diabetes screening, and an annual wellness visit, available for seniors with Medicare.  Also, check out Go4Life, an exercise and physical activity campaign from the National Institute on Aging at NIH.

Throughout the year, and especially during Older Americans Month in May, we urge all Americans to appreciate and celebrate the vitality, aspirations, and achievements of elders and their contributions to society.

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Get your blood pressure checked regularly

Do you or does someone you know have high blood pressure? Most likely, your answer is yes. More than one-third of adults in the United States have high blood pressure, and many don’t even know it. High blood pressure increases your risk of heart disease, the #1 killer worldwide, and many other diseases. That’s why it’s important to get your blood pressure checked regularly.

Medicare helps make checking your blood pressure easy. A blood pressure screening is covered in your “Welcome to Medicare” visit and your Yearly Wellness visit at no cost to you.

There are also many ways to prevent and help treat high blood pressure. Eating a healthy diet and avoiding sodium are easy ways to lower blood pressure. Maintaining a healthy weight and being physically active are also important. The surgeon general recommends at least 30 minutes of moderate physical activity most days of the week. You can also check your blood pressure between your yearly visits for free at many pharmacies, senior centers, and health fairs.

May is National High Blood Pressure Education Month, watch our video to learn more.

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Protect yourself from Hepatitis B

Did you know that 1.2 million people in the U.S. have chronic Hepatitis B, but many more people don’t know they’re infected because they have no symptoms? Hepatitis B is a contagious liver disease that can range in severity from a mild illness lasting a few weeks to a serious illness that can lead to liver disease or liver cancer.

Medicare can help keep you protected from Hepatitis B. The best way to prevent Hepatitis B is by getting the Hepatitis B vaccine, which is usually given as 3 shots over a 6-month period. You need to get all 3 shots for complete coverage. If you’re at high or medium risk for Hepatitis B, Medicare Part B will cover Hepatitis B shots for free.

Are you at risk for getting Hepatitis B? If you have hemophilia, End-Stage Renal Disease (ESRD), diabetes, or certain conditions that lower your resistance to infection, you have a higher risk for getting Hepatitis B increases.  Additionally, if you have a profession that puts you in frequent contact with blood or bodily fluids, you may be at a higher risk.

May is Hepatitis Awareness month. To find out more about preventing and treating Hepatitis B, visit the Centers for Disease Control.

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