Medicare

Over one million Americans rely on nursing homes for care, yet nursing homes face challenges in recruiting and retaining staff. Nursing homes rely on registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) to provide care, but staff shortages that increased during the COVID-19 pandemic have persisted.

This ASPE issue brief lays out a proposed comprehensive analytic framework to fully evaluate the impact of the CMS Innovation Center’s efforts on the Medicare program and the broader health care system as a whole to test innovative payment and service delivery models that reduce program expenditures while preserving or enhancing the quality of care.

The Centers for Medicare & Medicaid Services (CMS) Innovation Center is in the process of developing the Medicare $2 Drug List (M2DL) Model. This would allow Part D plan sponsors to offer a standardized list of generic drugs for a copayment of $2 or less for a month’s supply that would not be subject to prior authorization, quantity limits, or other utilization management restrictions.

In November 2024, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Program; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly proposed rule.

The purpose of this research was to understand the relationship between state Medicaid payment rates to nursing homes and those facilities’ costs of providing care to Medicaid residents.

This report highlights key programs, activities, and policies of HHS’ strategic approach to addressing social determinants of health, including early accomplishments to date and stories of the on-the-ground impact that these initiatives are making in people’s lives. These and other actions being taken by HHS, and across the federal government, as well as cross-sector initiatives at the com

Prior research from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and Research (PD&R) show older adults receiving federal housing assistance face disproportionately high rates of chronic conditions and health care utilization.

Effective January 1, 2023, the Inflation Reduction Act (IRA) eliminated cost sharing and deductibles for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) covered under Medicare Part D. In 2023, 10.3 million Medicare Part D enrollees received a recommended vaccine free of charge, which saved enrollees more than $400 million in out-of-pocket costs.

Patient navigation provides support and information to patients and their families to help navigate the complexities of health care services. These programs or services may include providing support and resources to inform clinical patient choices, financial responsibilities, and available social and community services.

The Inflation Reduction Act (IRA) is helping people with Medicare, including nearly 30 million women enrolled in Part D. Our review shows that, in 2020, about 733,000 women enrolled in Part D and B would have benefited from the IRA’s $35 insulin cap and, in 2021, about 2 million women would not have had any out-of-pocket costs for recommended adult vaccines covered by Part D.