CMS policy
Is the kidney care demo a bust?
A few years ago, CMS launched a big experiment to see if financial incentives and penalties would improve care for people with end-stage kidney disease. So far, it hasn't worked, a new study finds.
The model has been a historic effort, both because it's the largest such experiment in the history of American health care and because — unlike previous CMMI pilot programs — it's mandatory, Isabella Cueto writes.
And yet: Those sticks and carrots don't seem to be doing much. In a paper published in JAMA Health Forum on Sunday, researchers report that providers enrolled in the experiment aren't moving more patients to home dialysis or transplant than those in the control group. Read more about what that means and where care models may go from here.
on the hill
House panels set their sights on Obamacare
A trio of House committee leaders dispatched letters Monday to HHS watchdogs, asking about a recent report — from a conservative think tank — estimating that as many as five million people are erroneously enrolled in fully-subsidized ACA marketplace plans.
Their math equals out to a cost of $15 billion to $26 billion annually for American taxpayers. At the heart of this probe is a longtime GOP complaint that Biden officials have relaxed enrollment rules and extended subsidies that keep costs low for enrollees. Between the two, many people who shouldn't be eligible are reaping the benefits of no- to low-cost plans, the Republican committee chairs say.
"While individuals may reasonably misestimate their income at any given point, the scale of the problem suggests malicious intent from certain actors involved," the chairs of House E&C, Ways & Means and Judiciary write in the letter. But they ask for a full report from HHS by Dec. 15 this year, leaving no room for legislative action this session.
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