Mutual of Omaha PDP Exit

The Congressional Budget Office (CBO) estimates that spending on Part D benefits will total $120 billion in 2024, representing 14% of net Medicare outlays (net of offsetting receipts from premiums and state transfers).

Financing for Part D comes from general revenues (74%), beneficiary premiums (14%), and state contributions (11%). The monthly premium paid by enrollees is set to cover 25.5% of the cost of standard drug coverage.

For 2024, Medicare’s actuaries estimate that Part D plans will receive direct subsidy payments averaging $383 per enrollee overall, $2,588 for enrollees receiving the LIS, and $1,153 in reinsurance payments for very high-cost enrollees; employers are expected to receive, on average, $591 for retirees in employer-subsidy plans. Part D plans also receive additional risk-adjusted payments based on the health status of their enrollees, and plans’ potential total losses or gains are limited by risk-sharing arrangements with the federal government (“risk corridors”).


The real question that should be asked is this. How much longer will CMS continue to fund fat cat insurance carriers that promote MA plans?


Medicare spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had instead been covered by traditional Medicare. The Medicare Advantage spending amount includes the cost of extra benefits, funded by rebates, not available to traditional Medicare beneficiaries.

The higher Medicare spending per Medicare Advantage enrollee, compared to spending for similar beneficiaries under traditional Medicare, contributed an estimated $7 billion in additional spending in 2019.


I don't see how spending on Rx's is so high in our society.

It's not like every other commercial on TV is about medication that will allow me to have a dinner party with ambient light surrounded by friends - or an adventure in a vacation spot...
 
The Congressional Budget Office (CBO) estimates that spending on Part D benefits will total $120 billion in 2024, representing 14% of net Medicare outlays (net of offsetting receipts from premiums and state transfers).

Financing for Part D comes from general revenues (74%), beneficiary premiums (14%), and state contributions (11%). The monthly premium paid by enrollees is set to cover 25.5% of the cost of standard drug coverage.

For 2024, Medicare’s actuaries estimate that Part D plans will receive direct subsidy payments averaging $383 per enrollee overall, $2,588 for enrollees receiving the LIS, and $1,153 in reinsurance payments for very high-cost enrollees; employers are expected to receive, on average, $591 for retirees in employer-subsidy plans. Part D plans also receive additional risk-adjusted payments based on the health status of their enrollees, and plans’ potential total losses or gains are limited by risk-sharing arrangements with the federal government (“risk corridors”).


The real question that should be asked is this. How much longer will CMS continue to fund fat cat insurance carriers that promote MA plans?


Medicare spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had instead been covered by traditional Medicare. The Medicare Advantage spending amount includes the cost of extra benefits, funded by rebates, not available to traditional Medicare beneficiaries.

The higher Medicare spending per Medicare Advantage enrollee, compared to spending for similar beneficiaries under traditional Medicare, contributed an estimated $7 billion in additional spending in 2019.

The actual breakdown of funding is interesting. I knew they were subsidized but that's helpful.
 
I don't see how spending on Rx's is so high in our society.

It's not like every other commercial on TV is about medication that will allow me to have a dinner party with ambient light surrounded by friends - or an adventure in a vacation spot...
Remember when Martin Shkreli got in trouble a few years ago, when he gloated about raising the price of a daraprim 5,000 percent overnight... if he put his ego aside, he could have quietly raised the price slowly like the other Pharma manufacturers.

Instead it shed light on their practices, and how they can legally do that.

Fortunately for the Pharma industry, they were able to create distance from him, and make him the fall guy for the practice.

Much like the boiling frog story... the pharmaceutical raises the prices slowly
 

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