About health insurance/insurers
A Snapshot of Sources of Coverage Among Medicare Beneficiaries “KEY HIGHLIGHTS:
In 2022, Medicare enrollment was split equally between Medicare Advantage and traditional Medicare. Overall, more than 4 in 10 Medicare beneficiaries (44%), including beneficiaries in traditional Medicare and Medicare Advantage, had additional coverage from an employer or union sponsored plan (24%) or Medicaid (19%).
Nearly 90% of people in traditional Medicare had some form of additional coverage, such as Medigap (42%), employer or union-sponsored retiree health benefits (31%), or Medicaid (16%), but 11% (three million Medicare beneficiaries) had no additional coverage.
More than 40% of all Medicare Advantage enrollees also had some form of coverage from Medicaid (23%) or a union/employer sponsored retiree health plan (18%) in 2022.
Beneficiaries in traditional Medicare with Medigap and employer-sponsored insurance had higher incomes, were in relatively good health, had more years of education, and were less likely to be under age 65 with disabilities than all traditional Medicare beneficiaries.
As more beneficiaries have shifted to Medicare Advantage plans, the number of Medicare beneficiaries in traditional Medicare with no additional coverage has declined from 5.6 million in 2018 to 3.2 million in 2022. Traditional Medicare beneficiaries with no supplemental coverage were more likely to be under the age of 65 and have relatively lower incomes compared to traditional Medicare beneficiaries overall.
Medicare Advantage enrollees were more likely to be Black or Hispanic, self-report relatively poor health, have incomes below $20,000 per person, and have lower levels of education, compared to traditional Medicare beneficiaries in 2022.
Dual-eligible individuals accounted for a larger number and share of Medicare Advantage enrollees (7.0 million; 23%) than traditional Medicare beneficiaries (4.6 million; 16%) in 2022. Dual-eligible individuals in both traditional Medicare and Medicare Advantage were more likely to have lower incomes, self-report relatively poor health, identify as Black or Hispanic, and be under age 65 with disabilities than the overall Medicare population.”
Nearly 7 in 10 Medicare Beneficiaries Did Not Compare Plans During Medicare’s Open Enrollment Period “Key Takeaways
Overall, nearly 7 in 10 (69%) Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area during the 2021 open enrollment period, while 31% did so. A larger share of beneficiaries in traditional Medicare than in Medicare Advantage did not compare their own source of coverage with other plans (73% vs 65%).
Among Medicare Advantage enrollees, more than 4 in 10 (43%) did not review their current plan’s coverage to check for potential changes in their plan’s premiums or other out-of-pocket costs, while the remainder (57%) did so. A similar share (44%) did not review their current plan for potential changes in the kinds of treatments, drugs, and services that would be covered in the following year.
Most enrollees in Medicare Advantage prescription drug plans (82%) and stand-alone prescription drug plan (PDPs) (69%) did not compare their plan’s drug coverage with drug coverage offered by other plans in their area.
Medicare’s official information resources are used by half or fewer of Medicare beneficiaries, with just a quarter (26%) reporting calling the toll-free number, 4 in 10 (42%) reporting visiting the Medicare website, and slightly more than half (54%) reporting reading some or parts of the Medicare & You handbook.”
Healthcare costs at a post-pandemic high, US employers prioritize affordability and wellbeing “WTW’s 2024 Best Practices in Healthcare Survey found that U.S. employers project their healthcare costs will increase by 7.7% in 2025, compared with 6.9% in 2024 and 6.5% in 2023. As a result of this uptick in costs, employers are reaching beyond traditional cost-shifting strategies to improve healthcare affordability and employee health. More than half of employers (52%) plan to implement programs that will reduce total costs, and just as many (51%) intend to adopt plan design and network strategies that steer to lower-cost, higher-quality providers and sites of care. Only 34% expect to shift costs to employees through premium contributions, and just 20% will promote account-based health plans or high-deductible health plans.”
About pharma
FDA approves a novel drug for schizophrenia, a potential game changer “The U.S. Food and Drug Administration late Thursday approved a new kind of drug to treat schizophrenia, a breakthrough after 70 years of incremental innovation that appears to avoid side effects that cause many patients to stop taking their medication.
The new drug, Bristol Myers Squibb’s Cobenfy, targets a different area of the brain than traditional antipsychotic drugs to relieve symptoms like delusions without causing patients to gain weight, fall asleep and experience involuntary muscle jerking.”
About the public’s health
Raising Taxes On These Products Could Generate $3.7 Trillion, Says New Report “‘Health Taxes: A Compelling Policy for the Crises of Today’ just released on September 24 described what could happen if such taxes were raised so that prices of these products would be increased by 50% around the world. Such higher prices could discourage the use of these products and thus prevent the noncommunicable diseases or NCDs that tobacco, alcohol and sugary beverages may cause. At the same time, doing so could end up generating an additional $3.7 trillion in revenue over the next five years. And having an extra several trillion dollars available could be kind of helpful.”
WHO director general: A breakthrough global agreement on combatting antimicrobial resistance “At the U.N. General Assembly in New York on Thursday, all countries approved a major new political declaration to radically scale up efforts to combat antimicrobial resistance (AMR) — a major threat to modern medicine.”
The Uneven Surge in Diabetes in the United States “Takeaway
The overall prevalence of diabetes increased by 18.6% (P < .001) from 2012 to 2022, with the highest prevalence observed among non-Hispanic Black individuals (15.8%) and people aged ≥ 65 years (23.86%).
The likelihood of being diagnosed with diabetes was 1.15 times higher in men than in women, 5.16 times higher in adults aged 45-64 years than in those aged 18-24 years, and 3.64 times higher in those with obesity than in those with normal weight.
The risk for being diagnosed with diabetes was 1.60 times higher among Hispanic individuals, 1.67 times higher among non-Hispanic Asian individuals, and 2.10 times higher among non-Hispanic Black individuals than among non-Hispanic White individuals.
Individuals with a college education and higher income level were 24% and 41% less likely, respectively, to be diagnosed with diabetes.”