The Biden administration’s proposal to increase Medicare payments to hospitals in the next fiscal year is part of a broader plan that seeks to strengthen various aspects of the health system in the United States, but it does not stop generating controversy for more “good intentions” that the government has.
This is a proposed 2.6% increase for a particular coverage for patients using Medicare. This increase would represent a significant increase of $3.3 billion over the current year and is aimed not only at improving hospitals’ compensation for inpatient care, but also at implementing policy adjustments that address key areas of healthcare.
Will I Pay More for My Medicare Healthcare Coverage in 2025?
CMS has recently published a series of updates aimed at strengthening health equity and improving the coordination of surgical care in hospitals. These updates, which accompany the proposed rule, include various incentives and policies aimed at improving various aspects of health care.
Among the most significant actions is the modification in the definitions of severity of seven diagnostic codes used in the treatment of homeless people. This change aims to more accurately reflect every healthcare encounter in hospitals and improve the reliability and validity of the coded data.
In addition, the CMS are increasing supplemental payments for new technologies for gene therapies targeting diseases such as sickle cell anemia, which disproportionately affect underserved demographic groups. A separate payment will also be established for small independent hospitals that maintain a stock of essential medicines, and at least half of the new postgraduate medical education places available in 2026 will be allocated to psychiatry.
The response to these updates has been mixed. On the one hand, the U.S. Department of Health has expressed his commitment to equity in access to health care, regardless of patients’ financial difficulties or personal characteristics. On the other hand, organizations such as Premier Inc. they have highlighted the importance of voluntary models and have urged CMS to closely monitor the impact of these measures. Companies are especially concerned about the scope of the new prices, and how that may impact the budget of Medicare users.
The public will have 60 days to comment on the proposed rule, which is set to be published in the Federal Registrar May 2.
Medicare Parts a & B Premiums and Deductibles in 2024
This year, the standard monthly premium for Medicare Part B beneficiaries will be $174.70, which is an increase of $9.80 compared to the previous year. In addition, the annual deductible for all Part B beneficiaries will be $240 in 2024, an increase of $14 from the previous year.
The increases in the premium and the deductible are based mainly on projections of an increase in spending on medical care and, to a lesser extent, on adjustments in the payment policies for medicines purchased under the Prospective Payment system for Hospital Outpatients. This payment policy refers to the remedy for drug payment policies 340B, applicable for the period 2018-2022.
Table – Full Part B Coverage
| Beneficiaries who file individual tax returns with modified adjusted gross income: | Beneficiaries who file joint tax returns with modified adjusted gross income: | Income-Related Monthly Adjustment Amount | Total Monthly Premium Amount |
|---|---|---|---|
| Less than or equal to $103,000 | Less than or equal to $206,000 | $0.00 | $174.70 |
| Greater than $103,000 and less than or equal to $129,000 | Greater than $206,000 and less than or equal to $258,000 | $69.90 | $244.60 |
| Greater than $129,000 and less than or equal to $161,000 | Greater than $258,000 and less than or equal to $322,000 | $174.70 | $349.40 |
| Greater than $161,000 and less than or equal to $193,000 | Greater than $322,000 and less than or equal to $386,000 | $279.50 | $454.20 |
| Greater than $193,000 and less than $500,000 | Greater than $386,000 and less than $750,000 | $384.30 | $559.00 |
| Greater than or equal to $500,000 | Greater than or equal to $750,000 | $419.30 | $594.00 |