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Policy Brief: Medicare Modifications



May 20th, 2010
by Chris Fleming

The latest health policy brief from Health Affairs and the Robert Wood Johnson Foundation examines the changes to Medicare contained in recently passed health reform legislation. This is the most recent in a series of briefs that offer more context than fact sheets but provide quicker reads than most background papers. The information in the briefs is objective and reviewed by Health Affairs authors and other specialists with years of expertise in health policy.

Among the Medicare changes discussed in the new brief are:

Expanded prescription drug coverage. The newly enacted Patient Protection and Affordable Care Act strengthens Medicare prescription drug coverage subsidies for low-income Medicare beneficiaries. It also immediately begins phasing out the coverage gap known as the “doughnut hole” and fully closes the gap in 2020.

Expanded coverage of preventive services. Beginning in 2011, Medicare will pay the full cost of an annual wellness visit, and beneficiaries will pay no out-of-pocket costs for preventive services rated highly by the U.S. Preventive Services Task Force.

In addition, under health reform legislation, primary care practitioners will receive larger payments, higher-income households will face increased Medicare taxes, and private Medicare Advantage plans will see lower reimbursements unless they can demonstrate that they are providing high-quality care. The new legislation also gives Medicare more authority and resources to experiment with new payment and care delivery models.

Near-Term Changes in Health Insurance. An earlier health policy brief released on April 30 outlines changes to the private health insurance market that take effect this year and in 2011.

Stay tuned for futher briefs about health reform and other topics. You can sign up for e-mail alerts about upcoming briefs. The briefs are also available from the RWJF Web site. Please feel free to forward the briefs to any of your colleagues who are tracking health issues. We welcome feedback at hpbrief@healthaffairs.org.

In addition, the June issue of Health Affairs, to be released June 8, will feature comprehensive coverage of the newly passed health reform legislation.

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