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Explore full-page version For the first time since early June, both buy antibiotics-related deaths and new s declined last week in rural counties, according zithromax buy canada to a Daily Yonder analysis. New s in rural (nonmetropolitan) counties dropped by about 20%, to a total of 159,204. It’s the zithromax buy canada second consecutive week of declines in new s. Surprisingly, fewer buy antibiotics-related deaths were reported in rural counties last week.

Deaths fell by a modest 3%, to 3,102 zithromax buy canada. After previous surges, the number of buy antibiotics-related deaths continued to climb for several weeks after new s had peaked. Metropolitan s and deaths also fell. That means rural zithromax buy canada counties continue to have worse and death rates from buy antibiotics.

(See the graphs above.) The rural rate is two-thirds higher than the metropolitan rate (346 versus 207 per 100,000 residents). The rural death rate is zithromax buy canada 90% higher than the metropolitan one (6.73 versus 3.57 per 100,000). The rural rate is higher than the metro rate in 37 of the 47 states that contain nonmetropolitan counties. The rural death rate is higher in 38 states.

Alaska is the nation's zithromax buy canada new hotspot, both for rural and metropolitan s and deaths. s were up by more than 150% for both rural and urban areas. Statewide, deaths increased five fold to zithromax buy canada 83, up from 14 two weeks ago. Deaths in rural Alaska grew from three two weeks ago to 24 last week.

Like this story?. Sign up zithromax buy canada for our newsletter. This week’s report covers Sunday, September 26, through Saturday, October 2. Data comes zithromax buy canada from USA Facts, supplemented by the Centers for Disease Control and Prevention.

(See note at the bottom of the story for more information). Although overall rates have dropped, most of the nation (both metropolitan and rural) remains in the red zone, which is defined as having 100 or more new s per 100,000 residents for a week. The White House antibiotics task force has said communities above this threshold should take additional measures to contain the zithromax.Over 90% of metropolitan and rural counties were in the red zone last week.The number of rural zithromax buy canada red-zone counties dropped by 29. In Texas, 11 fewer rural counties were in the red zone.

Georgia dropped 10 counties from the red-zone list.There was more improvement in the number of counties with very-high rates of , defined as 500 or more cases zithromax buy canada per 100,000 for the week. (These counties are shown in black [nonmetro] and grey [metro] on the map above.)The number of counties in the very-high category in rural areas dropped by about 20%, from 496 counties two weeks ago to 391 last week. States with the biggest declines were Kentucky (105 fewer very-high counties), West Virginia (down 62), Montana (down 51), Ohio (down 51), and Tennessee (down 50).Despite overall improvement in rates, about a third of the nation’s 1,976 nonmetropolitan counties had more s last week than two weeks ago. States with the largest number of rural counties with higher rates were Texas (46 additional zithromax buy canada rural counties), Minnesota (44), Michigan (42), Kansas (40), Nebraska (38), and Iowa (25).

Data This story defines rural as nonmetropolitan counties, using the list created by the Office of Management and Budget in 2013. For more on rural definitions, visit the zithromax buy canada USDA Economic Research Service website. Data is from USA Facts and runs through October 2, except for Nebraska, Florida, and New Jersey, where there were data gaps. For these states, we supplemented the data with information from the Centers for Disease Control and Prevention.

CDC data covers the week ending October zithromax buy canada 3. You Might Also LikeDear Reader, Thank you for following the Me&MyDoctor blog. I'm writing to let you know we are moving the public health stories authored by Texas physicians, residents, and medical students, and patients to the Texas Medical Association's social media channels. Be sure to follow us on all our social media accounts (Facebook, Twitter, Instagram) as well as Texas Medicine Today to access these stories and more.

We look forward to seeing you there.Best, Olivia Suarez Me&My Doctor Editor.

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The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis.The Medicare Advantage spending includes the cost of extra benefits, such as vision, dental and hearing coverage that are funded by rebates and not covered for zithromax usa beneficiaries in traditional Medicare. The extra benefits have likely contributed to years of steady increases in Medicare Advantage enrollment, which reached 22 million in 2019 (36% of all beneficiaries) and 26 million this year (42%).At the same time, Medicare Advantage spending has risen steadily, and is projected to rise to $664 billion by 2029, up from $348 billion this year. Half of the projected increase is due to growth in enrollment, while the remaining half is attributable to growth in federal payments per enrollee, after accounting zithromax usa for inflation. The projected growth in spending per Medicare Advantage enrollee is driven in part by the expectation that federal bonus payments that plans receive based on their quality ratings will continue to rise.The higher payments for Medicare Advantage — $11,844 per person in Medicare Advantage vs.

$11,523 in traditional Medicare in 2019 — have led to higher federal spending than would have occurred under traditional Medicare and higher Medicare Part B premiums zithromax usa paid by all beneficiaries, including those in traditional Medicare.The higher spending is attributed to features of the Medicare Advantage payment system, including how benchmarks for plan payments are set, as well as the risk adjustment process, that is intended to compensate plans more for higher cost enrollees. That has attracted the attention of the Biden Administration, which in its 2022 budget expressed support for reforming payments to private plans as part of efforts to extend the solvency of the Medicare Hospital Insurance Trust Fund and improve affordability for beneficiaries. Additionally, Medicare Advantage plans have come under scrutiny over inaccurate coding practices that contribute to higher risk scores for their enrollees, and higher payments from Medicare.The new KFF analysis finds that if spending per Medicare Advantage enrollee were 2 percent less each year than the amount projected by the Medicare actuaries – a scenario similar to a recommendation made zithromax usa by the federal Medicare Payment Advisory Commission (MedPAC) — then total Medicare spending would be $82 billion lower than projected between 2021 and 2029.Under a different scenario, if the growth in per person spending on beneficiaries in Medicare Advantage were held to the same rate of growth in spending on beneficiaries in traditional Medicare, then total Medicare program spending would be $183 billion lower than projected between 2021 and 2029, the analysis finds.Reducing Medicare Advantage payments from their projected amounts could have uncertain effects on the availability of plans that offer extra benefits for Medicare Advantage enrollees, or plan profits, unless plans are able to lower administrative costs and operate more efficiently.The full analysis, Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges, as well as other data and analyses about Medicare Advantage, can be found at kff.org.The number of people enrolled in Medicare has increased steadily in recent years, and along with it, Medicare spending. In particular, enrollment in Medicare Advantage, the private plan alternative to traditional Medicare, has more than doubled over the last decade.

Notably, Medicare spending is higher and growing faster per person for beneficiaries in Medicare Advantage than in traditional zithromax usa Medicare. As enrollment in Medicare Advantage continues to grow, these trends have important implications for total Medicare spending, and costs incurred by beneficiaries. In its 2022 budget, the Biden Administration expressed support for reforming payments to private plans as part zithromax usa of efforts to extend the solvency of the Medicare Hospital Insurance (HI) Trust Fund and improve affordability for beneficiaries.This analysis examines Medicare spending per person for beneficiaries in Medicare Advantage, relative to traditional Medicare. We build on prior work published by the Medicare Payment Advisory Commission (MedPAC) and the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT) to provide estimates of the amount Medicare would have spent for Medicare Advantage enrollees had they been covered under traditional Medicare in 2019 (the most recent year for which data are available).

We use publicly available data from CMS that includes spending for people who were enrolled in both Part A and Part B of traditional Medicare, by category of service, as well as information on average risk scores and enrollment by county. This allows zithromax usa us to calculate per-person spending for beneficiaries in traditional Medicare on a basis comparable to federal payments per enrollee in Medicare Advantage. We also examine the extent to which the projected growth in Medicare Advantage spending is attributable to the growth in enrollment and the increase in spending per person. We then illustrate zithromax usa potential savings to the Medicare program between 2021 and 2029 under two alternative scenarios where Medicare Advantage spending per person is lower or grows slower than under current projections.

(See Methodology for more details on the data and analytic approach.)Our analysis finds: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.Growth in Medicare Advantage enrollment explains half of the projected increase in total Medicare Advantage spending between 2021 and 2029 and half zithromax usa is attributable to growth in Medicare payments per Medicare Advantage enrollee, after accounting for inflation.If spending per Medicare Advantage enrollee was 2 percent less each year than projected by the Medicare actuaries, similar to the projected impact of a recommendation made by MedPAC, total Medicare spending would be $82 billion lower between 2021 and 2029. If instead Medicare payments per Medicare Advantage enrollee grew at the same rate as is projected for spending per person in traditional Medicare (4.4% vs 5.3%), total Medicare spending would be $183 billion lower between 2021 and 2029.Background on Payments to Medicare Advantage PlansMedicare beneficiaries have the option to receive their Medicare benefits through either the traditional Medicare program or by enrolling in a private health plan, such as an HMO or PPO, that contracts with Medicare, called Medicare Advantage. Medicare pays zithromax usa Medicare Advantage plans a set amount for each enrollee.

The payment is determined through an annual process in which plans submit “bids” for how much they estimate it will cost to provide benefits covered under Medicare Parts A and B for an average beneficiary. The bids submitted by each plan are compared to a benchmark, which is an amount based on a set percentage of the projected zithromax usa average spending for beneficiaries in traditional Medicare in the same county. The benchmarks range from 95 percent in high spending counties to 115 percent in low spending counties. The benchmarks are subject zithromax usa to caps, meaning they cannot exceed the benchmarks that were in place before the Affordable Care Act.

In addition, the benchmarks are increased by 5 percent for plans that receive at least 4 out of 5 stars under the quality bonus program, and 10 percent in certain “double bonus” counties.Plans that bid below the benchmark receive a portion of the difference between the bid and the benchmark as a “rebate” (50 percent for plans with 3 or fewer stars, 65 percent for plans with 3.5 or 4 stars, and 70 percent for plans with 5 stars). Rebates must be used to reduce cost sharing, subsidize the standard Part B and/or Part D premium, or pay for supplemental benefits (such as vision, dental, and hearing). A portion of the rebate may also be used for administrative costs or retained as zithromax usa profit. Plans that bid above their benchmark receive the benchmark amount, and enrollees pay an additional premium equal to the difference between the bid and benchmark.

The payments to plans are risk adjusted, based on the health status and other characteristics of enrollees, including age, sex, zithromax usa and Medicaid enrollment. Medicare payments are higher for plans with higher average risk scores because their enrollees are expected to incur higher costs.While traditional Medicare spending is used to establish benchmarks, actual payments to Medicare Advantage plans can be higher or lower than spending for comparable beneficiaries in traditional Medicare. Changes in the Affordable Care Act initially reduced Medicare zithromax usa Advantage benchmarks. However, since 2017, benchmarks have risen on average, which increases the maximum possible payment a plan can receive.

When benchmarks increase, plans that bid zithromax usa below the benchmark may be able to retain the same amount of rebate dollars, and thus offer the same level of extra benefits, while increasing their bid for Part A and B services. Alternatively, these plans could bid the same (or even slightly less) and receive higher rebate payments as the difference between the benchmark and bid widens because the benchmark is higher. Either response zithromax usa increases the payment Medicare Advantage plans receive as benchmarks increase. One reason for the recent increase in benchmarks is that more plans are in bonus status, and thus have 5 percent (or 10 percent in double bonus counties) added to their benchmark.

In 2021, 81 zithromax usa percent of Medicare Advantage enrollees are in plans that receive a bonus payment. Similarly, rebates increase as star ratings increase, because plans with higher star ratings retain a larger percent of the difference between the benchmark and bid as a rebate.In addition, risk adjustment can lead to higher payments for Medicare Advantage enrollees than would have been spent in traditional Medicare. This is because risk scores are largely based on diagnoses, and more diagnoses generally increase a beneficiary’s risk score, providing an incentive for diagnoses to be coded more comprehensively for Medicare Advantage enrollees than occurs for traditional Medicare beneficiaries. MedPAC estimates that this more comprehensive coding of diagnoses in zithromax usa Medicare Advantage increased risk scores 9.1 percent relative to traditional Medicare in 2019.

There is also some concern that Medicare Advantage plans submit inaccurate diagnoses that increase risk scores and result in overpayments. The Health and Human Services Office of the Inspector General is currently conducting a targeted review of documentation submitted by Medicare Advantage organizations to determine whether diagnoses and associated risk zithromax usa scores comply with federal regulations. And in July, the Department of Justice announced that they were intervening in a False Claims Act lawsuit alleging that Kaiser Permanente had submitted inaccurate diagnoses codes for Medicare Advantage enrollees.FindingsSpending per personMedicare spent $321 more per person for Medicare Advantage enrollees than it would have spent for the same beneficiaries had they been covered under traditional Medicare in 2019. After adjusting for differences in health status and the geographic distribution of Medicare Advantage enrollees and traditional Medicare beneficiaries, spending per person for services covered under Parts A and B totaled $11,523 in 2019 for beneficiaries zithromax usa in traditional Medicare.

This estimate for traditional Medicare reflects the categories of spending that are covered by Medicare payments to Medicare Advantage plans, and so excludes spending on hospice and payments for graduate medical education but includes administrative expenses. In addition, it adjusts for the impact of more intense coding of zithromax usa diagnoses in Medicare Advantage relative to traditional Medicare, as estimated by MedPAC, which makes Medicare Advantage enrollees look like they are in worse health. (See Methodology for additional discussion.)In the same year, federal payments to Medicare Advantage plans were $11,844 per enrollee, or $321 more per person than Medicare would have spent if these beneficiaries had instead been covered by traditional Medicare. In other words, Medicare Advantage payments zithromax usa were about 103 percent of spending for comparable traditional Medicare beneficiaries.

The higher spending occurred despite changes in law made by the Affordable Care Act that reduced payments to plans over time (which MedPAC estimated at 114 percent of traditional Medicare beneficiary spending in 2009).As described above, Medicare payments per Medicare Advantage enrollee include two components. Bid-based expenditures, which reflect the plan’s expected costs for providing services covered under Medicare Parts A and B (adjusted for health risk), and rebates, which pay for the cost of benefits not available to zithromax usa traditional Medicare beneficiaries, including reduced cost sharing, subsidized Part B and Part D premiums, and coverage of additional benefits, such as vision, dental and hearing. In 2019, the bid-based portion of the Medicare Advantage payment was $10,848 and the rebate portion was $996.Higher Medicare payments per Medicare Advantage enrollee increased total Medicare spending by an estimated $7 billion in 2019. Across the approximately 22 million people enrolled in Medicare Advantage in 2019, higher spending of $321 per person led to about $7 billion in additional spending in that year.

That is equal to about 3 percent of all Medicare Advantage spending in 2019.Projected growth in Medicare Advantage spendingGrowth in Medicare Advantage enrollment explains half of the zithromax usa projected growth in Medicare Advantage spending between 2021 and 2029, after adjusting for inflation. Between 2021 and 2029, federal spending on payments to Medicare Advantage plans is projected to increase by $316 billion, from $348 billion to $664 billion. After accounting for inflation (which represents $108 billion of this increase), the remaining $208 zithromax usa billion is explained by growth in payments per person ($105 billion, or 50 percent) and growth in enrollment ($104 billion, or 50 percent) (Figure 1).Figure 1. Growth in Medicare Advantage Enrollment Explains Half of the Projected Increase in Medicare Advantage Spending through 2029Notably, the rebate portion of Medicare Advantage payments, which must be used to cover the cost of additional benefits not available to traditional Medicare beneficiaries, is projected to grow between 2021 and 2029.

Rebates account for about 10 percent of Medicare Advantage payments in 2021 ($35 billion of $348 zithromax usa billion) and are projected to rise to 12 percent ($80 billion of $664 billion) in 2029.Medicare spending is projected to grow faster for Medicare Advantage enrollees than traditional Medicare beneficiaries. Spending per person in Medicare Advantage is projected to grow 5.3 percent a year on average between 2021 and 2029, an amount which is similar across plan types (based on KFF analysis of data from the 2020 Medicare Trustees Report). The projected growth in Medicare Advantage spending per person is somewhat higher than the 4.4 percent average annual growth projected for beneficiaries in traditional Medicare (see Methodology for details on data and methods).According to the Medicare actuaries, the higher projected growth in Medicare payments per Medicare Advantage enrollee are in part explained by faster projected zithromax usa growth in the rebate portion of the payment. Rebates are projected to grow nearly 8 percent a year on average, which the actuaries attribute to “assumed increases in quality bonus payments and increases in benchmarks.”It is also possible that the faster expected increase in spending per person in Medicare Advantage compared to traditional Medicare through 2029 is due in part to an assumption that sicker and higher cost beneficiaries, such as those dually eligible for Medicare and Medicaid, will enroll in Medicare Advantage at a higher rate than in traditional Medicare.

For example, the number of Medicare Advantage enrollees in special needs plans (SNPs), which included zithromax usa just over half of all dually eligible beneficiaries in Medicare Advantage in 2019, is expected to increase slightly by 2029. However, the change is relatively small, and even if it represents only half of the total increase in Medicare Advantage enrollment by dually eligible beneficiaries, it suggests the projected increase in spending per Medicare Advantage enrollee is being driven by other factors, such as Medicare Advantage payment methodology. Additionally, starting in 2021, all Medicare beneficiaries with end-stage renal disease (ESRD) are eligible to enroll in a Medicare Advantage plan. Though beneficiaries with ESRD have substantially higher costs than the average Medicare beneficiary, they represent less than 1 percent of all Medicare beneficiaries, and so increased enrollment by beneficiaries with ESRD is likely to explain a relatively small portion of the growth in per-person spending in Medicare Advantage.Alternative projections for Medicare zithromax usa Advantage spendingIf Medicare Advantage spending per person was 2 percent less a year than projected, similar to the simulated effect of recommended payment changes from MedPAC, total Medicare spending would be $82 billion lower through 2029.

MedPAC has proposed changes to how Medicare Advantage benchmarks are calculated and estimate these changes would result in a 2 percent reduction in Medicare Advantage payments in a single year. Applying this zithromax usa payment reduction to the projected Medicare Advantage payments per enrollee in each year between 2022 and 2029, total Medicare Advantage spending would be $82 billion lower through 2029 (Figure 2). The decrease is approximately 1 percent of total Medicare benefit spending over these years (and 2 percent of Medicare Advantage spending).Even with the reduction in aggregate spending under this scenario where Medicare Advantage payments are reduced by 2 percent per year, projected Medicare spending per Medicare Advantage enrollee would still be higher and grow faster than projected spending per person in traditional Medicare. MedPAC expects implementing changes to the benchmark policy that result in a 2 percent reduction in payments in a given year would have only a modest effect on access to plans with lower cost sharing and reduced Part B and D zithromax usa premiums.

For example, in their simulations, the vast majority (over 95 percent) of Medicare beneficiaries would continue to have access to Medicare Advantage plans that offer reduced cost sharing and Part B and/or D premium reductions. The number of plan sponsors and plan choices would vary across geographic areas, as they do under zithromax usa current policy, but would be somewhat reduced. In the quartile of counties with the lowest traditional Medicare spending per person, MedPAC estimates an average of 5 plan sponsors would offer 12 different plans (compared to 6 plans sponsors who offered 22 different plans in 2020). In the quartile of counties with the highest spending per person in traditional Medicare, an average of 8 plan sponsors would zithromax usa offer 22 different Medicare Advantage plans (compared to the same number of sponsors who offered 27 plans in 2020).Under an alternative, illustrative scenario, where Medicare Advantage spending per person grew at the same rate as is projected for traditional Medicare, spending would be $183 billion lower between 2021 and 2029.

For this scenario, we calculated the difference in projected Medicare spending if Medicare payments per person to Medicare Advantage plans grew at the same rate as spending per person in traditional Medicare (4.4 percent) between 2021 and 2029, rather than the higher 5.3 percent growth rate projection. While this approach is not directly pegged to a specific policy proposal, zithromax usa it illustrates the potential for savings, of, for example, a cap on the growth in total Medicare Advantage payments per enrollee. To adjust to such a cap, plans could find additional efficiencies in the coverage of Part A and B services, reduce supplemental benefits, restrict the future growth in supplemental benefits, lower administrative costs, reduce profits, or some combination of each. Limiting the growth in Medicare payment per Medicare Advantage enrollee directly or indirectly could also be achieved through other payment reforms.Under the scenario where per-person spending growth in Medicare Advantage and traditional Medicare is equivalent, total Medicare Advantage spending over 2021 to 2029 would be $183 billion lower (Figure 2).

For context, the savings under this scenario represents 4 percent zithromax usa of projected Medicare Advantage spending over this time period (and 2 percent of total Medicare benefit spending). That compares to an expected reduction in Medicare Advantage spending of 8.9 percent between 2010 and 2019 due to changes in the Affordable Care Act (based on CBO’s estimate of the health care law and its March 2009 baseline). While spending per person would grow at the same rate in both Medicare Advantage and traditional Medicare under this scenario, payments per Medicare zithromax usa Advantage enrollee would be higher than spending per beneficiary in traditional Medicare because of higher projected spending per person in Medicare Advantage in 2021. Comparing the two alternative scenarios, the reduction in Medicare Advantage spending is similar in the initial years of the time period.

However, the Medicare savings accrue more rapidly under the scenario zithromax usa where growth in payments per Medicare Advantage enrollee is equal to the rate of growth in spending per person in traditional Medicare. This is because savings from lower growth compound over time. (Toggle between the two zithromax usa scenarios to see the year-by-year savings under each scenario in Figure 3).These estimates assume no changes to projected enrollment, which may occur if supplemental benefits, cost sharing, or other features of Medicare Advantage plans change in response to lower payments from the federal government. However, while it is not possible to know exactly how plans will respond to lower payments, previous analyses of past payment changes demonstrate that plans have found savings elsewhere in order to maintain rebate dollars to fund supplemental benefits that may appeal to enrollees.

For example, MedPAC examined the response of Medicare Advantage plans that lost bonus status between 2018 and 2019 and zithromax usa found that these plans reduced their profits and administrative costs, and had lower growth in their projected Part A and B costs compared to other plans. This allowed the plans to continue to provide similar levels of supplemental benefits. Further, despite predictions by CBO, Medicare actuaries, and others that enrollment in Medicare Advantage would fall following the reductions in payment to Medicare Advantage plans enacted as part of the Affordable Care Act, enrollment never declined zithromax usa and has instead risen rapidly. Plans offer more generous supplemental benefits in 2021 than at any other point in the program’s history and Medicare Advantage markets are robust, with the average Medicare beneficiary having more than 30 Medicare Advantage plans to choose from in 2021.

ConclusionHistorically, one goal of the Medicare Advantage program was to leverage the efficiencies of managed care to reduce Medicare spending. However, the program zithromax usa has never generated savings relative to traditional Medicare. In fact, the opposite is true. As a result, Medicare Advantage plans have zithromax usa been able to offer an increasingly robust set of extra benefits not available to beneficiaries in traditional Medicare.

The annual cost of the rebate dollars used to pay for the extra benefits – $1,680 per Medicare Advantage enrollee for non-employer, non-SNP plans in 2021 – more than offset any savings that Medicare Advantage plans generate by bidding below the benchmark set by CMS for covering Part A and B services. The extra benefits improve coverage for beneficiaries who choose Medicare Advantage plans and have likely contributed zithromax usa to the substantial increase in Medicare Advantage enrollment. But the higher payments have also led to higher Medicare spending than would have occurred under traditional Medicare and higher Medicare Part B premiums paid by all beneficiaries, including those in traditional Medicare.Our analysis finds that Medicare Advantage payments per enrollee in 2019 were approximately 103 percent of spending per person for comparable beneficiaries covered by traditional Medicare, consistent with estimates based on data submitted by private plans as part of the bidding process and concurrent projections by CMS of future spending in traditional Medicare. MedPAC’s most recent analysis of the relationship between Medicare Advantage payments and spending in traditional Medicare suggests that the difference has widened, with 2021 payments per zithromax usa Medicare Advantage enrollee estimated to total 104 percent of spending in traditional Medicare.

That trend is in part attributed to the rise in the rebate component of Medicare Advantage payments, which increased 14 percent between 2020 and 2021. While part of the zithromax usa increase in rebates stems from a decrease in how much private plans bid to provide coverage of Part A and B services, other features of the Medicare Advantage payment methodology, including the quality bonus program payments and benchmark policy contribute to both the recent and projected growth in rebates, and in turn, total Medicare Advantage spending. For example, under the quality bonus program, payments from the federal government to Medicare Advantage plans will total $11.6 billion in 2021, at least a portion of which was paid as the rebate.MedPAC recently recommended changes to how plan payments are calculated, observing that because most plans currently bid well below the cost of providing Part A and B services in traditional Medicare, there is an opportunity for the Medicare program to share in these efficiencies. Their simulations indicate that a 2 percent reduction in payments would not significantly affect access to private zithromax usa plans or supplemental benefits.

A reduction in Medicare Advantage payments consistent with the simulated effect of MedPAC’s recommendations, would result in Medicare program payments per enrollee that would remain higher and still grow faster than spending under traditional Medicare. Alternatively, bringing Medicare Advantage spending growth in line with projected growth in traditional Medicare would achieve more than twice as much savings. Under that scenario, the absolute level of payments per enrollee to private plans would still be higher than spending per zithromax usa person for beneficiaries in traditional Medicare. Reduced federal payments could mean Medicare Advantage enrollees see fewer extra benefits and higher cost sharing and premiums compared to today (but still lower costs than compared to traditional Medicare without supplemental coverage), but plans could also reduce profits or administrative costs to make up the difference.

Further, savings of this magnitude would be less than zithromax usa half of those included in the Affordable Care Act, which were followed by a period of robust Medicare Advantage growth.Over the next decade, Medicare Advantage enrollment is expected to continue to grow. As more Medicare beneficiaries enroll in private plans, differences in Medicare payments across Medicare Advantage and traditional Medicare will lead to even higher Medicare spending, and more generous benefits for beneficiaries in Medicare Advantage than traditional Medicare. That higher spending increases Part B premiums zithromax usa paid by all Medicare beneficiaries, including those who are not in a Medicare Advantage plan, and contribute to the financing challenges facing the Medicare HI Trust Fund. Further, these projections raise questions of equity between Medicare Advantage and traditional Medicare because the faster growth in spending per Medicare Advantage enrollee, compared to traditional Medicare beneficiaries, is in part due to rising rebates to private plans, which cover the cost of benefits not available to traditional Medicare beneficiaries.

Although taking steps to address the fiscal challenges facing Medicare are not front and center in current Medicare policy discussions, policymakers may soon be on the lookout for options zithromax usa to achieve Medicare savings to fund other spending priorities or extend the solvency of the Medicare HI Trust Fund. This analysis suggests that reducing the difference in payments between Medicare Advantage and traditional Medicare would generate savings, with the potential for reductions in extra benefits for Medicare Advantage enrollees.This work was supported in part by Arnold Ventures. We value zithromax usa our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 zithromax buy canada billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis.The Medicare Advantage spending includes the cost of extra benefits, such as vision, dental and hearing coverage that are funded by rebates and not covered for beneficiaries in traditional Medicare. The extra benefits have likely contributed to years of steady increases in Medicare Advantage enrollment, which reached 22 million in 2019 (36% of all beneficiaries) and 26 million this year (42%).At the same time, Medicare Advantage spending has risen steadily, and is projected to rise to $664 billion by 2029, up from $348 billion this year. Half of the projected increase is due to growth in enrollment, while the remaining half is attributable to growth in federal payments per enrollee, zithromax buy canada after accounting for inflation. The projected growth in spending per Medicare Advantage enrollee is driven in part by the expectation that federal bonus payments that plans receive based on their quality ratings will continue to rise.The higher payments for Medicare Advantage — $11,844 per person in Medicare Advantage vs. $11,523 in traditional Medicare in 2019 — have led to higher federal spending than would have occurred under traditional Medicare and higher Medicare zithromax buy canada Part B premiums paid by all beneficiaries, including those in traditional Medicare.The higher spending is attributed to features of the Medicare Advantage payment system, including how benchmarks for plan payments are set, as well as the risk adjustment process, that is intended to compensate plans more for higher cost enrollees.

That has attracted the attention of the Biden Administration, which in its 2022 budget expressed support for reforming payments to private plans as part of efforts to extend the solvency of the Medicare Hospital Insurance Trust Fund and improve affordability for beneficiaries. Additionally, Medicare Advantage plans have come under scrutiny over inaccurate coding practices that contribute to higher risk scores for their enrollees, and higher payments from Medicare.The new KFF analysis finds that if spending per Medicare Advantage enrollee were zithromax buy canada 2 percent less each year than the amount projected by the Medicare actuaries – a scenario similar to a recommendation made by the federal Medicare Payment Advisory Commission (MedPAC) — then total Medicare spending would be $82 billion lower than projected between 2021 and 2029.Under a different scenario, if the growth in per person spending on beneficiaries in Medicare Advantage were held to the same rate of growth in spending on beneficiaries in traditional Medicare, then total Medicare program spending would be $183 billion lower than projected between 2021 and 2029, the analysis finds.Reducing Medicare Advantage payments from their projected amounts could have uncertain effects on the availability of plans that offer extra benefits for Medicare Advantage enrollees, or plan profits, unless plans are able to lower administrative costs and operate more efficiently.The full analysis, Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges, as well as other data and analyses about Medicare Advantage, can be found at kff.org.The number of people enrolled in Medicare has increased steadily in recent years, and along with it, Medicare spending. In particular, enrollment in Medicare Advantage, the private plan alternative to traditional Medicare, has more than doubled over the last decade. Notably, Medicare spending is higher and growing faster per person for beneficiaries in Medicare Advantage than zithromax buy canada in traditional Medicare. As enrollment in Medicare Advantage continues to grow, these trends have important implications for total Medicare spending, and costs incurred by beneficiaries.

In its 2022 budget, the Biden Administration expressed support for reforming payments to private plans as part of efforts to extend the solvency of the Medicare Hospital Insurance (HI) Trust Fund zithromax buy canada and improve affordability for beneficiaries.This analysis examines Medicare spending per person for beneficiaries in Medicare Advantage, relative to traditional Medicare. We build on prior work published by the Medicare Payment Advisory Commission (MedPAC) and the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT) to provide estimates of the amount Medicare would have spent for Medicare Advantage enrollees had they been covered under traditional Medicare in 2019 (the most recent year for which data are available). We use publicly available data from CMS that includes spending for people who were enrolled in both Part A and Part B of traditional Medicare, by category of service, as well as information on average risk scores and enrollment by county. This allows us to calculate per-person spending for beneficiaries in traditional Medicare on a basis comparable to federal payments zithromax buy canada per enrollee in Medicare Advantage. We also examine the extent to which the projected growth in Medicare Advantage spending is attributable to the growth in enrollment and the increase in spending per person.

We then illustrate potential savings to the Medicare program between 2021 and 2029 under two alternative scenarios where Medicare Advantage spending per person is lower or grows slower than under zithromax buy canada current projections. (See Methodology for more details on the data and analytic approach.)Our analysis finds: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.Growth in Medicare Advantage enrollment explains half of the projected increase in total Medicare Advantage spending between 2021 and 2029 and half is attributable to growth in Medicare payments per Medicare Advantage enrollee, after accounting for inflation.If spending per Medicare Advantage enrollee was 2 percent less each year than projected by the Medicare actuaries, similar to the projected impact zithromax buy canada of a recommendation made by MedPAC, total Medicare spending would be $82 billion lower between 2021 and 2029. If instead Medicare payments per Medicare Advantage enrollee grew at the same rate as is projected for spending per person in traditional Medicare (4.4% vs 5.3%), total Medicare spending would be $183 billion lower between 2021 and 2029.Background on Payments to Medicare Advantage PlansMedicare beneficiaries have the option to receive their Medicare benefits through either the traditional Medicare program or by enrolling in a private health plan, such as an HMO or PPO, that contracts with Medicare, called Medicare Advantage. Medicare pays zithromax buy canada Medicare Advantage plans a set amount for each enrollee.

The payment is determined through an annual process in which plans submit “bids” for how much they estimate it will cost to provide benefits covered under Medicare Parts A and B for an average beneficiary. The bids submitted by each plan are compared to a benchmark, which is an amount based on a set percentage of the projected average spending for beneficiaries in traditional zithromax buy canada Medicare in the same county. The benchmarks range from 95 percent in high spending counties to 115 percent in low spending counties. The benchmarks are subject to caps, meaning they cannot exceed the zithromax buy canada benchmarks that were in place before the Affordable Care Act. In addition, the benchmarks are increased by 5 percent for plans that receive at least 4 out of 5 stars under the quality bonus program, and 10 percent in certain “double bonus” counties.Plans that bid below the benchmark receive a portion of the difference between the bid and the benchmark as a “rebate” (50 percent for plans with 3 or fewer stars, 65 percent for plans with 3.5 or 4 stars, and 70 percent for plans with 5 stars).

Rebates must be used to reduce cost sharing, subsidize the standard Part B and/or Part D premium, or pay for supplemental benefits (such as vision, dental, and hearing). A portion of the rebate may also be used zithromax buy canada for administrative costs or retained as profit. Plans that bid above their benchmark receive the benchmark amount, and enrollees pay an additional premium equal to the difference between the bid and benchmark. The payments to plans are zithromax buy canada risk adjusted, based on the health status and other characteristics of enrollees, including age, sex, and Medicaid enrollment. Medicare payments are higher for plans with higher average risk scores because their enrollees are expected to incur higher costs.While traditional Medicare spending is used to establish benchmarks, actual payments to Medicare Advantage plans can be higher or lower than spending for comparable beneficiaries in traditional Medicare.

Changes in the Affordable Care Act initially reduced Medicare Advantage zithromax buy canada benchmarks. However, since 2017, benchmarks have risen on average, which increases the maximum possible payment a plan can receive. When benchmarks increase, plans that bid below the benchmark may be able to retain the same amount of rebate dollars, and thus offer the same level of extra benefits, while increasing their bid zithromax buy canada for Part A and B services. Alternatively, these plans could bid the same (or even slightly less) and receive higher rebate payments as the difference between the benchmark and bid widens because the benchmark is higher. Either response increases the payment Medicare Advantage zithromax buy canada plans receive as benchmarks increase.

One reason for the recent increase in benchmarks is that more plans are in bonus status, and thus have 5 percent (or 10 percent in double bonus counties) added to their benchmark. In 2021, 81 percent of Medicare Advantage enrollees are in plans that receive zithromax buy canada a bonus payment. Similarly, rebates increase as star ratings increase, because plans with higher star ratings retain a larger percent of the difference between the benchmark and bid as a rebate.In addition, risk adjustment can lead to higher payments for Medicare Advantage enrollees than would have been spent in traditional Medicare. This is because risk scores are largely based on diagnoses, and more diagnoses generally increase a beneficiary’s risk score, providing an incentive for diagnoses to be coded more comprehensively for Medicare Advantage enrollees than occurs for traditional Medicare beneficiaries. MedPAC estimates that this more comprehensive coding of diagnoses in zithromax buy canada Medicare Advantage increased risk scores 9.1 percent relative to traditional Medicare in 2019.

There is also some concern that Medicare Advantage plans submit inaccurate diagnoses that increase risk scores and result in overpayments. The Health and Human Services zithromax buy canada Office of the Inspector General is currently conducting a targeted review of documentation submitted by Medicare Advantage organizations to determine whether diagnoses and associated risk scores comply with federal regulations. And in July, the Department of Justice announced that they were intervening in a False Claims Act lawsuit alleging that Kaiser Permanente had submitted inaccurate diagnoses codes for Medicare Advantage enrollees.FindingsSpending per personMedicare spent $321 more per person for Medicare Advantage enrollees than it would have spent for the same beneficiaries had they been covered under traditional Medicare in 2019. After adjusting for differences in health status and the geographic distribution of Medicare Advantage enrollees and zithromax buy canada traditional Medicare beneficiaries, spending per person for services covered under Parts A and B totaled $11,523 in 2019 for beneficiaries in traditional Medicare. This estimate for traditional Medicare reflects the categories of spending that are covered by Medicare payments to Medicare Advantage plans, and so excludes spending on hospice and payments for graduate medical education but includes administrative expenses.

In addition, it adjusts for the impact of more intense coding of diagnoses in Medicare Advantage relative to traditional Medicare, as estimated by MedPAC, which makes zithromax buy canada Medicare Advantage enrollees look like they are in worse health. (See Methodology for additional discussion.)In the same year, federal payments to Medicare Advantage plans were $11,844 per enrollee, or $321 more per person than Medicare would have spent if these beneficiaries had instead been covered by traditional Medicare. In other words, Medicare Advantage payments were about 103 percent of spending for comparable traditional Medicare zithromax buy canada beneficiaries. The higher spending occurred despite changes in law made by the Affordable Care Act that reduced payments to plans over time (which MedPAC estimated at 114 percent of traditional Medicare beneficiary spending in 2009).As described above, Medicare payments per Medicare Advantage enrollee include two components. Bid-based expenditures, which reflect the plan’s expected costs for providing services covered zithromax buy canada under Medicare Parts A and B (adjusted for health risk), and rebates, which pay for the cost of benefits not available to traditional Medicare beneficiaries, including reduced cost sharing, subsidized Part B and Part D premiums, and coverage of additional benefits, such as vision, dental and hearing.

In 2019, the bid-based portion of the Medicare Advantage payment was $10,848 and the rebate portion was $996.Higher Medicare payments per Medicare Advantage enrollee increased total Medicare spending by an estimated $7 billion in 2019. Across the approximately 22 million people enrolled in Medicare Advantage in 2019, higher spending of $321 per person led to about $7 billion in additional spending in that year. That is equal to about 3 percent of all Medicare Advantage spending in 2019.Projected growth in Medicare Advantage spendingGrowth in Medicare Advantage enrollment explains half of the zithromax buy canada projected growth in Medicare Advantage spending between 2021 and 2029, after adjusting for inflation. Between 2021 and 2029, federal spending on payments to Medicare Advantage plans is projected to increase by $316 billion, from $348 billion to $664 billion. After accounting for inflation (which represents $108 billion of this increase), the remaining $208 billion is explained by growth in payments per person ($105 billion, or 50 percent) and growth in enrollment ($104 zithromax buy canada billion, or 50 percent) (Figure 1).Figure 1.

Growth in Medicare Advantage Enrollment Explains Half of the Projected Increase in Medicare Advantage Spending through 2029Notably, the rebate portion of Medicare Advantage payments, which must be used to cover the cost of additional benefits not available to traditional Medicare beneficiaries, is projected to grow between 2021 and 2029. Rebates account for about 10 percent of Medicare Advantage payments in 2021 ($35 billion of $348 billion) and are projected to rise to 12 zithromax buy canada percent ($80 billion of $664 billion) in 2029.Medicare spending is projected to grow faster for Medicare Advantage enrollees than traditional Medicare beneficiaries. Spending per person in Medicare Advantage is projected to grow 5.3 percent a year on average between 2021 and 2029, an amount which is similar across plan types (based on KFF analysis of data from the 2020 Medicare Trustees Report). The projected growth in Medicare Advantage spending per person is somewhat higher than the 4.4 percent average annual growth projected for beneficiaries in traditional Medicare (see Methodology for details on data zithromax buy canada and methods).According to the Medicare actuaries, the higher projected growth in Medicare payments per Medicare Advantage enrollee are in part explained by faster projected growth in the rebate portion of the payment. Rebates are projected to grow nearly 8 percent a year on average, which the actuaries attribute to “assumed increases in quality bonus payments and increases in benchmarks.”It is also possible that the faster expected increase in spending per person in Medicare Advantage compared to traditional Medicare through 2029 is due in part to an assumption that sicker and higher cost beneficiaries, such as those dually eligible for Medicare and Medicaid, will enroll in Medicare Advantage at a higher rate than in traditional Medicare.

For example, the number of Medicare Advantage enrollees in special needs plans (SNPs), which zithromax buy canada included just over half of all dually eligible beneficiaries in Medicare Advantage in 2019, is expected to increase slightly by 2029. However, the change is relatively small, and even if it represents only half of the total increase in Medicare Advantage enrollment by dually eligible beneficiaries, it suggests the projected increase in spending per Medicare Advantage enrollee is being driven by other factors, such as Medicare Advantage payment methodology. Additionally, starting in 2021, all Medicare beneficiaries with end-stage renal disease (ESRD) are eligible to enroll in a Medicare Advantage plan. Though beneficiaries with ESRD have substantially higher costs than the average Medicare beneficiary, they represent less than 1 percent of all Medicare beneficiaries, and so increased enrollment by beneficiaries with ESRD is likely to explain a relatively small portion of the growth in per-person spending in Medicare Advantage.Alternative projections for Medicare Advantage spendingIf Medicare Advantage spending per person was 2 percent less a year than projected, similar to the simulated effect of recommended payment changes from MedPAC, total Medicare spending would be $82 billion lower zithromax buy canada through 2029. MedPAC has proposed changes to how Medicare Advantage benchmarks are calculated and estimate these changes would result in a 2 percent reduction in Medicare Advantage payments in a single year.

Applying this payment reduction to the projected Medicare Advantage payments per enrollee in each year between 2022 and 2029, total zithromax buy canada Medicare Advantage spending would be $82 billion lower through 2029 (Figure 2). The decrease is approximately 1 percent of total Medicare benefit spending over these years (and 2 percent of Medicare Advantage spending).Even with the reduction in aggregate spending under this scenario where Medicare Advantage payments are reduced by 2 percent per year, projected Medicare spending per Medicare Advantage enrollee would still be higher and grow faster than projected spending per person in traditional Medicare. MedPAC expects implementing changes to the benchmark policy that result in a 2 percent reduction in payments in a given year would have only a modest effect on access to plans with lower cost sharing and reduced Part B and D premiums zithromax buy canada. For example, in their simulations, the vast majority (over 95 percent) of Medicare beneficiaries would continue to have access to Medicare Advantage plans that offer reduced cost sharing and Part B and/or D premium reductions. The number of plan sponsors and plan choices would vary across geographic zithromax buy canada areas, as they do under current policy, but would be somewhat reduced.

In the quartile of counties with the lowest traditional Medicare spending per person, MedPAC estimates an average of 5 plan sponsors would offer 12 different plans (compared to 6 plans sponsors who offered 22 different plans in 2020). In the quartile of counties with the highest spending per person in traditional Medicare, an average of 8 plan sponsors would offer 22 different Medicare Advantage plans (compared to the same number zithromax buy canada of sponsors who offered 27 plans in 2020).Under an alternative, illustrative scenario, where Medicare Advantage spending per person grew at the same rate as is projected for traditional Medicare, spending would be $183 billion lower between 2021 and 2029. For this scenario, we calculated the difference in projected Medicare spending if Medicare payments per person to Medicare Advantage plans grew at the same rate as spending per person in traditional Medicare (4.4 percent) between 2021 and 2029, rather than the higher 5.3 percent growth rate projection. While this approach is not directly pegged zithromax buy canada to a specific policy proposal, it illustrates the potential for savings, of, for example, a cap on the growth in total Medicare Advantage payments per enrollee. To adjust to such a cap, plans could find additional efficiencies in the coverage of Part A and B services, reduce supplemental benefits, restrict the future growth in supplemental benefits, lower administrative costs, reduce profits, or some combination of each.

Limiting the growth in Medicare payment per Medicare Advantage enrollee directly or indirectly could also be achieved through other payment reforms.Under the scenario where per-person spending growth in Medicare Advantage and traditional Medicare is equivalent, total Medicare Advantage spending over 2021 to 2029 would be $183 billion lower (Figure 2). For context, zithromax buy canada the savings under this scenario represents 4 percent of projected Medicare Advantage spending over this time period (and 2 percent of total Medicare benefit spending). That compares to an expected reduction in Medicare Advantage spending of 8.9 percent between 2010 and 2019 due to changes in the Affordable Care Act (based on CBO’s estimate of the health care law and its March 2009 baseline). While spending per person would grow at the same rate in both Medicare Advantage and traditional Medicare under this scenario, payments per Medicare Advantage enrollee would be higher than spending per beneficiary in traditional Medicare because of higher projected spending per person in Medicare Advantage zithromax buy canada in 2021. Comparing the two alternative scenarios, the reduction in Medicare Advantage spending is similar in the initial years of the time period.

However, the Medicare savings accrue more rapidly under the scenario where growth in payments per Medicare Advantage enrollee is equal to the rate zithromax buy canada of growth in spending per person in traditional Medicare. This is because savings from lower growth compound over time. (Toggle between zithromax buy canada the two scenarios to see the year-by-year savings under each scenario in Figure 3).These estimates assume no changes to projected enrollment, which may occur if supplemental benefits, cost sharing, or other features of Medicare Advantage plans change in response to lower payments from the federal government. However, while it is not possible to know exactly how plans will respond to lower payments, previous analyses of past payment changes demonstrate that plans have found savings elsewhere in order to maintain rebate dollars to fund supplemental benefits that may appeal to enrollees. For example, MedPAC examined the response of Medicare Advantage plans that lost bonus status between 2018 and 2019 and found that these zithromax buy canada plans reduced their profits and administrative costs, and had lower growth in their projected Part A and B costs compared to other plans.

This allowed the plans to continue to provide similar levels of supplemental benefits. Further, despite predictions by CBO, Medicare actuaries, and others that enrollment in Medicare Advantage would fall following the reductions in payment to Medicare Advantage plans enacted as part of the Affordable Care Act, enrollment never declined and zithromax buy canada has instead risen rapidly. Plans offer more generous supplemental benefits in 2021 than at any other point in the program’s history and Medicare Advantage markets are robust, with the average Medicare beneficiary having more than 30 Medicare Advantage plans to choose from in 2021. ConclusionHistorically, one goal of the Medicare Advantage program was to leverage the efficiencies of managed care to reduce Medicare spending. However, the program has never generated savings relative to zithromax buy canada traditional Medicare.

In fact, the opposite is true. As a result, Medicare Advantage plans have been zithromax buy canada able to offer an increasingly robust set of extra benefits not available to beneficiaries in traditional Medicare. The annual cost of the rebate dollars used to pay for the extra benefits – $1,680 per Medicare Advantage enrollee for non-employer, non-SNP plans in 2021 – more than offset any savings that Medicare Advantage plans generate by bidding below the benchmark set by CMS for covering Part A and B services. The extra benefits improve coverage for beneficiaries who choose Medicare Advantage plans and have likely contributed to the substantial zithromax buy canada increase in Medicare Advantage enrollment. But the higher payments have also led to higher Medicare spending than would have occurred under traditional Medicare and higher Medicare Part B premiums paid by all beneficiaries, including those in traditional Medicare.Our analysis finds that Medicare Advantage payments per enrollee in 2019 were approximately 103 percent of spending per person for comparable beneficiaries covered by traditional Medicare, consistent with estimates based on data submitted by private plans as part of the bidding process and concurrent projections by CMS of future spending in traditional Medicare.

MedPAC’s most recent analysis of the relationship between Medicare Advantage payments and spending in traditional Medicare suggests that the difference has widened, with 2021 payments per Medicare Advantage enrollee estimated to total 104 percent zithromax buy canada of spending in traditional Medicare. That trend is in part attributed to the rise in the rebate component of Medicare Advantage payments, which increased 14 percent between 2020 and 2021. While part of the increase in rebates stems from a decrease in how much private plans bid zithromax buy canada to provide coverage of Part A and B services, other features of the Medicare Advantage payment methodology, including the quality bonus program payments and benchmark policy contribute to both the recent and projected growth in rebates, and in turn, total Medicare Advantage spending. For example, under the quality bonus program, payments from the federal government to Medicare Advantage plans will total $11.6 billion in 2021, at least a portion of which was paid as the rebate.MedPAC recently recommended changes to how plan payments are calculated, observing that because most plans currently bid well below the cost of providing Part A and B services in traditional Medicare, there is an opportunity for the Medicare program to share in these efficiencies. Their simulations indicate that a 2 percent reduction in payments would not significantly zithromax buy canada affect access to private plans or supplemental benefits.

A reduction in Medicare Advantage payments consistent with the simulated effect of MedPAC’s recommendations, would result in Medicare program payments per enrollee that would remain higher and still grow faster than spending under traditional Medicare. Alternatively, bringing Medicare Advantage spending growth in line with projected growth in traditional Medicare would achieve more than twice as much savings. Under that scenario, the absolute level of payments per enrollee to zithromax buy canada private plans would still be higher than spending per person for beneficiaries in traditional Medicare. Reduced federal payments could mean Medicare Advantage enrollees see fewer extra benefits and higher cost sharing and premiums compared to today (but still lower costs than compared to traditional Medicare without supplemental coverage), but plans could also reduce profits or administrative costs to make up the difference. Further, savings of this zithromax buy canada magnitude would be less than half of those included in the Affordable Care Act, which were followed by a period of robust Medicare Advantage growth.Over the next decade, Medicare Advantage enrollment is expected to continue to grow.

As more Medicare beneficiaries enroll in private plans, differences in Medicare payments across Medicare Advantage and traditional Medicare will lead to even higher Medicare spending, and more generous benefits for beneficiaries in Medicare Advantage than traditional Medicare. That higher zithromax buy canada spending increases Part B premiums paid by all Medicare beneficiaries, including those who are not in a Medicare Advantage plan, and contribute to the financing challenges facing the Medicare HI Trust Fund. Further, these projections raise questions of equity between Medicare Advantage and traditional Medicare because the faster growth in spending per Medicare Advantage enrollee, compared to traditional Medicare beneficiaries, is in part due to rising rebates to private plans, which cover the cost of benefits not available to traditional Medicare beneficiaries. Although taking steps to address the fiscal challenges facing Medicare are not front and center in current Medicare policy discussions, policymakers may soon be on the lookout zithromax buy canada for options to achieve Medicare savings to fund other spending priorities or extend the solvency of the Medicare HI Trust Fund. This analysis suggests that reducing the difference in payments between Medicare Advantage and traditional Medicare would generate savings, with the potential for reductions in extra benefits for Medicare Advantage enrollees.This work was supported in part by Arnold Ventures.

We value zithromax buy canada our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities. Methodology.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. There should be an interval of at least 12 hours between doses.

Zithromax and doxycycline

It is that zithromax and doxycycline time of http://www.luckjunky.com/amoxil-online-in-canada/ year again when we must confront the cyclic moods we call Seasonal Affective Disorder, or S.A.D. Each year during the winter months, some individuals experience depression that is zithromax and doxycycline cyclic and predictable. This mood change usually starts sometime around October or November and subsides around March or April.

Symptoms may include zithromax and doxycycline. A drop in energy levelDifficulty concentratingBecoming increasingly irritableExperiencing a change in appetite, craving sweets or carbsOversleepingIncreased fatigueWeight gain While depression can be caused by major life changes, certain medications, or alcohol and other drugs, S.A.D. Is believed to be caused by a change in zithromax and doxycycline circadian rhythm.

The circadian rhythm is the repeating cycle that regulates zithromax and doxycycline day and night activities and is fueled by the secretion of melatonin from the pineal gland in response to darkness. Whereas melatonin induces sleep, the hormone serotonin produces energy and feelings of happiness, and increases with exposure to bright light. Individuals who have Seasonal Affective Disorder show a longer duration zithromax and doxycycline of melatonin release during nights and winter months, due to shorter daylight hours.

Circadian rhythm is a 24-hour repeating rhythm in the human brain that regulates day and night activities. Between midnight and 2 a.m., zithromax and doxycycline melatonin levels peak and then fall gradually until morning. Sunlight informs the brain of a new day, suppresses melatonin and zithromax and doxycycline increases serotonin.

During the winter months, there is later morning light, causing melatonin levels to peak later and remain elevated two or more hours longer than during the summer months. When this occurs the body zithromax and doxycycline thinks it needs more sleep. There are several options available zithromax and doxycycline in treating S.A.D.

If an individual is experiencing mild symptoms that do not interfere too much with their activities of daily living, light therapy can be effective. Light therapy is used to synchronize the circadian rhythm and sleep/awake cycle with a special lamp that is 10-20 times brighter than ordinary indoor zithromax and doxycycline bulbs, for about 30 minutes each day. Typical light therapy is generated at 10,000 lux using a light box, and is most effective if used in the morning.

These boxes are available through durable medical equipment programs, zithromax and doxycycline or can be found by shopping online. Other effective treatments of S.A.D include medications and talk therapy. Antidepressants can zithromax and doxycycline be used to treat symptoms of seasonal affective disorder.

Talk therapy can be successful in identifying and modifying negative thoughts and behaviors and zithromax and doxycycline increasing coping skills to manage stress. All persons affected by S.A.D. Regardless of their choice of treatment should engage in activities such as walking or other exercise, eating a well-balanced diet, establishing regular sleep/wake times, and participating in winter sports zithromax and doxycycline or hobbies that will lead to productive use of time.

An important thing to remember about Seasonal Affective Disorder is that it only lasts a few months during the year and that treatment is available to lessen the symptoms. For more information about Seasonal zithromax and doxycycline Affective Disorder there are many books, such as Winter Blues. Seasonal Affective Disorder—What It Is and how to Overcome It by Norman Rosenthal, M.D., or websites from reputable experts, such as zithromax and doxycycline the National Institute of Health’s www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder or the National Institute of Mental Health’s www.nimh.nih.gov.

For those who need moreintense treatment for S.A.D. Or other mental health conditions MidMichiganHealth provides an intensive outpatient program called Psychiatric PartialHospitalization Program at MidMichigan Medical zithromax and doxycycline Center – Gratiot. Thoseinterested in more information about the PPH program may call (989) 466-3253.Those interested in more information on MidMichigan’s comprehensive behavioralhealth programs may visit www.midmichigan.org/mentalhealth..

It is that time zithromax buy canada of year again when we must confront the cyclic moods we Amoxil online in canada call Seasonal Affective Disorder, or S.A.D. Each year during the winter zithromax buy canada months, some individuals experience depression that is cyclic and predictable. This mood change usually starts sometime around October or November and subsides around March or April. Symptoms may zithromax buy canada include. A drop in energy levelDifficulty concentratingBecoming increasingly irritableExperiencing a change in appetite, craving sweets or carbsOversleepingIncreased fatigueWeight gain While depression can be caused by major life changes, certain medications, or alcohol and other drugs, S.A.D.

Is believed to be caused by a change in circadian rhythm zithromax buy canada. The circadian zithromax buy canada rhythm is the repeating cycle that regulates day and night activities and is fueled by the secretion of melatonin from the pineal gland in response to darkness. Whereas melatonin induces sleep, the hormone serotonin produces energy and feelings of happiness, and increases with exposure to bright light. Individuals who have Seasonal Affective Disorder show a longer duration of melatonin release during nights and winter months, due to shorter zithromax buy canada daylight hours. Circadian rhythm is a 24-hour repeating rhythm in the human brain that regulates day and night activities.

Between midnight and 2 a.m., melatonin levels peak and then fall gradually until morning zithromax buy canada. Sunlight informs the brain of a new day, suppresses melatonin and increases zithromax buy canada serotonin. During the winter months, there is later morning light, causing melatonin levels to peak later and remain elevated two or more hours longer than during the summer months. When this occurs the body thinks zithromax buy canada it needs more sleep. There are several options available in treating S.A.D zithromax buy canada.

If an individual is experiencing mild symptoms that do not interfere too much with their activities of daily living, light therapy can be effective. Light therapy is used to synchronize the circadian rhythm and sleep/awake cycle with a special lamp that is 10-20 times brighter than ordinary indoor bulbs, for about 30 minutes each day zithromax buy canada. Typical light therapy is generated at 10,000 lux using a light box, and is most effective if used in the morning. These boxes are available through durable medical equipment programs, or can zithromax buy canada be found by shopping online. Other effective treatments of S.A.D include medications and talk therapy.

Antidepressants can be used to treat symptoms of zithromax buy canada seasonal affective disorder. Talk therapy can be successful zithromax buy canada in identifying and modifying negative thoughts and behaviors and increasing coping skills to manage stress. All persons affected by S.A.D. Regardless of their choice of treatment should engage in activities such as walking or zithromax buy canada other exercise, eating a well-balanced diet, establishing regular sleep/wake times, and participating in winter sports or hobbies that will lead to productive use of time. An important thing to remember about Seasonal Affective Disorder is that it only lasts a few months during the year and that treatment is available to lessen the symptoms.

For more information about Seasonal Affective Disorder there are many books, such as Winter zithromax buy canada Blues. Seasonal Affective Disorder—What It zithromax buy canada Is and how to Overcome It by Norman Rosenthal, M.D., or websites from reputable experts, such as the National Institute of Health’s www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder or the National Institute of Mental Health’s www.nimh.nih.gov. For those who need moreintense treatment for S.A.D. Or other mental health conditions zithromax buy canada MidMichiganHealth provides an intensive outpatient program called Psychiatric PartialHospitalization Program at MidMichigan Medical Center – Gratiot. Thoseinterested in more information about the PPH program may call (989) 466-3253.Those interested in more information on MidMichigan’s comprehensive behavioralhealth programs may visit www.midmichigan.org/mentalhealth..

Azithromycin zithromax side effects

A 33-year old man was found to have Visit Your URL a second antibiotics some azithromycin zithromax side effects four-and-a-half months after he was diagnosed with his first, from which he recovered. The man, who showed no symptoms, was diagnosed when he returned to Hong Kong after a trip to Spain.I am a virologist with expertise in antibioticses and enterozithromaxes, and I’ve been curious about res since the beginning of the zithromax. Because people infected with antibiotics can often test positive for the zithromax for weeks to months, likely due to the sensitivity of the test and leftover RNA fragments, the only way to really answer the question of re is by sequencing the viral genome at the time azithromycin zithromax side effects of each and looking for differences in the genetic code.There is no published peer-review report on this man – only a press release from the University of Hong Kong – although reports say the work will be published in the journal Clinical Infectious Diseases. Here I address some questions raised by the current news reports.Why wasn’t the man immune to re?.

Immunity to azithromycin zithromax side effects endemic antibioticses – those that cause symptoms of the common cold – is relatively short-lived, with res occurring even within the same season. So it isn’t completely surprising that re with antibiotics, the zithromax that causes buy antibiotics, might be possible.Immunity is complex and involves multiple mechanisms in the body. That includes the generation of antibodies – through what’s known as the adaptive immune response – and through the actions of T-cells, which can help to educate the azithromycin zithromax side effects immune system and to specifically eliminate zithromax-infected cells. However, researchers around the world are still learning about immunity to this zithromax and so can’t say for sure, based on this one case, whether re will be a cause for broad concern.[Get the best of The Conversation, every weekend.

Sign up for our weekly newsletter.]How different is azithromycin zithromax side effects the second strain that infected the Hong Kong man?. “Strain” has a particular definition when referring to zithromaxes. Often a different “strain” is a zithromax that behaves differently in some way azithromycin zithromax side effects. The antibiotics that infected this man in Europe is likely not a new strain.A STAT News article reports that the genetic make up of the sequenced zithromax from the patient’s second had 24 nucleotides – building blocks of the zithromax’s RNA genome – that differed from the antibiotics isolate that infected him the first time.antibiotics has a genome that is made up of about 30,000 nucleotides, so the zithromax from the man’s second was roughly 0.08% different than the original in genome sequence.

That shows that the zithromax that caused the second was new. Not a recurrence of the first zithromax.The man was azithromycin zithromax side effects asymptomatic – what does that mean?. The man wasn’t suffering any of the hallmark buy antibiotics symptoms which might mean he had some degree of protective immunity to the second because he didn’t seem sick. But this is difficult to prove.I see three azithromycin zithromax side effects possible explanations.

The first is that the immunity he gained from the first protected him and allowed for a mild second . Another possibility is that azithromycin zithromax side effects the was mild because he was presymptomatic, and went on to develop symptoms in the coming days. Finally, sometimes s with antibiotics are asymptomatic – at the moment it is difficult to determine whether this was due to the differences in the zithromax or in the host.What can we say about re based on this one case?. Only that it seems to be possible after azithromycin zithromax side effects enough time has elapsed.

We do not know how likely or often it is to occur.Should people who have recovered from buy antibiotics still wear a mask?. As we are still learning about how humans develop immunity to antibiotics after , my recommendation is for continued masking, hand hygiene and distancing practices, even after recovery from azithromycin zithromax side effects buy antibiotics, to protect against the potential for re.Megan Culler Freeman is a Pediatric Infectious Diseases Fellow at the University of Pittsburgh. This article originally appeared on The Conversation and is republished under a Creative Commons license. Read the original here..

A 33-year https://www.wolf-garten.com/how-to-buy-cipro-in-usa/ old man was found to have zithromax buy canada a second antibiotics some four-and-a-half months after he was diagnosed with his first, from which he recovered. The man, who showed no symptoms, was diagnosed when he returned to Hong Kong after a trip to Spain.I am a virologist with expertise in antibioticses and enterozithromaxes, and I’ve been curious about res since the beginning of the zithromax. Because people zithromax buy canada infected with antibiotics can often test positive for the zithromax for weeks to months, likely due to the sensitivity of the test and leftover RNA fragments, the only way to really answer the question of re is by sequencing the viral genome at the time of each and looking for differences in the genetic code.There is no published peer-review report on this man – only a press release from the University of Hong Kong – although reports say the work will be published in the journal Clinical Infectious Diseases. Here I address some questions raised by the current news reports.Why wasn’t the man immune to re?.

Immunity to endemic antibioticses zithromax buy canada – those that cause symptoms of the common cold – is relatively short-lived, with res occurring even within the same season. So it isn’t completely surprising that re with antibiotics, the zithromax that causes buy antibiotics, might be possible.Immunity is complex and involves multiple mechanisms in the body. That includes the generation of antibodies – through what’s known as the adaptive immune response – and through the actions of T-cells, which can help to educate the immune system and to specifically eliminate zithromax-infected cells zithromax buy canada. However, researchers around the world are still learning about immunity to this zithromax and so can’t say for sure, based on this one case, whether re will be a cause for broad concern.[Get the best of The Conversation, every weekend.

Sign up for our weekly zithromax buy canada newsletter.]How different is the second strain that infected the Hong Kong man?. “Strain” has a particular definition when referring to zithromaxes. Often a zithromax buy canada different “strain” is a zithromax that behaves differently in some way. The antibiotics that infected this man in Europe is likely not a new strain.A STAT News article reports that the genetic make up of the sequenced zithromax from the patient’s second had 24 nucleotides – building blocks of the zithromax’s RNA genome – that differed from the antibiotics isolate that infected him the first time.antibiotics has a genome that is made up of about 30,000 nucleotides, so the zithromax from the man’s second was roughly 0.08% different than the original in genome sequence.

That shows that the zithromax that caused the second was new. Not a recurrence of the first zithromax.The man was asymptomatic zithromax buy canada – what does that mean?. The man wasn’t suffering any of the hallmark buy antibiotics symptoms which might mean he had some degree of protective immunity to the second because he didn’t seem sick. But this is zithromax buy canada difficult to prove.I see three possible explanations.

The first is that the immunity he gained from the first protected him and allowed for a mild second . Another possibility is that the zithromax buy canada was mild because he was presymptomatic, and went on to develop symptoms in the coming days. Finally, sometimes s with antibiotics are asymptomatic – at the moment it is difficult to determine whether this was due to the differences in the zithromax or in the host.What can we say about re based on this one case?. Only that it seems to be zithromax buy canada possible after enough time has elapsed.

We do not know how likely or often it is to occur.Should people who have recovered from buy antibiotics still wear a mask?. As we are still learning about how humans develop immunity to antibiotics after zithromax buy canada , my recommendation is for continued masking, hand hygiene and distancing practices, even after recovery from buy antibiotics, to protect against the potential for re.Megan Culler Freeman is a Pediatric Infectious Diseases Fellow at the University of Pittsburgh. This article originally appeared on The Conversation and is republished under a Creative Commons license. Read the original here..

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SALT LAKE buy zithromax for pets CITY, Sept see this site. 09, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst", buy zithromax for pets Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Patrick Nelli, Chief Financial Officer, and Adam Brown, Senior Vice President, Investor Relations, will participate in the 2020 Cantor Global Virtual Healthcare Conference on Tuesday, September 15, 2020, which will include a fireside chat presentation at 1:20 p.m.

ET. A live audio webcast and replay of this presentation will be available at https://ir.healthcatalyst.com/investor-relations.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Investor Relations Contact:Adam BrownSenior Vice President, Investor Relations+1 (855)-309-6800ir@healthcatalyst.comHealth Catalyst Media Contact:Kristen BerryVice President, Public Relations+1 (617) 234-4123+1 (774) 573-0455 (m)kberry@we-worldwide.com Source.

Health Catalyst, Inc.SALT LAKE CITY, Sept. 8, 2020 /PRNewswire/ -- Health Catalyst, Inc. ("Health Catalyst," Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that it has completed its seventh annual and first ever virtual Healthcare Analytics Summit (HAS), with record registration of more than 3,500 attendees.

Keynotes included Dr. Amy Abernethy, Principal Deputy Commissioner and Acting CIO of the U.S. Food and Drug Administration, Michael Dowling, CEO of Northwell Health, Vice Admiral Raquel Bono, MD, and many others. Other business updates include:The Vitalware, LLC ("VitalWare"), transaction has closed, and integration is underway of the Yakima, Washington-based provider of revenue workflow optimization and analytics SaaS technology solutions for health organizations.

This is another example of Health Catalyst's ability to scale software on top of its cloud-based Data Operating System (DOS™). DOS will further enhance the analytics insights made available by Vitalware's technology by combining charge and revenue data with claims, cost, and quality data. Vitalware's flagship offering is a Best in KLAS chargemaster management solution that delivers results for the complex regulatory and compliance functions needed by all healthcare provider systems. "As announced on August 11, 2020, we entered into an acquisition agreement to acquire Vitalware and expected to close the acquisition in Q3 or Q4 of 2020.

We are pleased to announce that we closed the acquisition on September 1, 2020. We are thrilled to formalize the combination of our solutions for the benefit of our customers and the industry," said CEO Dan Burton. On its upcoming Q3 2020 earnings call, Health Catalyst will share the impact of Vitalware on its Q3 2020 financial performance, which will not be significant given the timing of the acquisition, as well as update its full year 2020 guidance to include the impact of Vitalware. Health Catalyst Co-Founder Steve Barlow has returned from his three-year full-time volunteer mission for the Church of Jesus Christ of Latter-Day Saints, having served as Mission President of the Ecuador Quito Mission.

He has rejoined Health Catalyst's companywide Leadership Team as a Senior Vice President, responsible for some of the company's largest customer relationships. Dan Burton said, "We couldn't be more excited about Steve's return to Health Catalyst. His energy, dedication and commitment to transforming healthcare launched our journey and will continue to make us better and stronger. Steve is leading and overseeing all aspects of our partnerships with some of our largest and longest-standing customers.

Steve's extraordinary experience and capability enable him to be a critical partner and leader in enabling these customers' continued improvement and success." "My experience over the past three years in Ecuador reinforced for me how fortunate I am to be in a country with high-quality healthcare," said Barlow. "It has been invigorating to return to Health Catalyst and witness the incredible growth and expansion that has occurred over the past few years. We are better positioned than ever before to achieve our mission of being the catalyst for massive, measurable, data-informed healthcare improvement. I am grateful to be reunited with our longstanding team members and customers, and I'm thrilled to get to know and work alongside our new customers and teammates in this critical work." Effective October 1, 2020, Chief Technology Officer Dale Sanders will be transitioning to a Senior Advisor role with Health Catalyst, and the company is pleased to announce that one of Dale's longtime protégés and colleagues, Bryan Hinton, will serve as Health Catalyst's next Chief Technology Officer.

Hinton joined Health Catalyst in 2012 and currently serves as the Senior Vice President and General Manager of the DOS Platform Business. He will continue to lead this business in addition to assuming the responsibilities of CTO. He has been instrumental in the development and integration of DOS and has been working directly with Dale and other technology leaders at Health Catalyst for many years. His experience prior to joining Health Catalyst includes four years with the .NET Development Center of Excellence at The Church of Jesus Christ of Latter-Day Saints, where he established the architectural guidance of all .NET projects.

Previously, at Intel, he was responsible for the development and implementation of Intel's factory data warehouse product installed at Intel global factories. Hinton graduated from Brigham Young University with a BS in Computer Science. "Dale has been central to Health Catalyst's growth and success and we are grateful to him for his many years of service to our company and to the broader healthcare industry," said Dan Burton, CEO of Health Catalyst. "Thanks to Dale's vision, passion, innovative thinking and broad-based industry experience and perspective, Health Catalyst has grown from a handful of clients to a large number of organizations relying on us as their digital transformation partner, helping the healthcare ecosystem to constantly learn and improve.

Dale's technology leadership was critical to the company's overall maturation, and I am convinced that we could not have grown and scaled as we have without Dale's foundational leadership and contributions. We are grateful to continue our association with Dale in the months and years ahead in his next role as a Senior Advisor to the company." Burton added, "We are thrilled to see Bryan Hinton take on this added role after having demonstrated his technology leadership prowess during the course of his tenure at Health Catalyst and having been mentored by Dale for many years. Bryan is well-prepared and ready for this additional responsibility, and we extend our congratulations to him." "I feel like a parent saying goodbye to my kids at their college graduation," said Dale Sanders. "Many of the concepts we first developed and applied over 20 years ago at Intermountain and then later refined during my tenure as CIO at Northwestern had a big influence on our technology and products at Health Catalyst.

The vision of the Data Operating System and its application ecosystem originated in the real-world healthcare operations and research trenches of Northwestern. At Health Catalyst, I had the wonderful opportunity to lead the teams who made that vision a reality for the benefit of the entire industry. None of it would have been possible without Bryan Hinton leading the DOS team and Eric Just and Dan Unger leading the application development teams. We've been working side-by-side for many years to make the vision real.

Bryan is the consummate modern CTO from outside of healthcare that healthcare needs. I've always described Eric as having a manufacturing engineer's mindset with a healthcare data and software engineer's skills, with Dan Unger leveraging his deep domain expertise in financial transformation to oversee the development of meaningful applications and solutions so relevant for CFOs. I'm honored and thrilled to step aside and turn the future over to their very capable hands. Under their leadership, the best is yet to come for Health Catalyst's technology." About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations, and is committed to being the catalyst for massive, measurable, data-informed healthcare improvement.

Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Media Contact:Kristen BerrySenior Vice President, Public Relations+1 (617) 234-4123HealthCatalyst@we-worldwide.com View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-completes-hosting-of-the-largest-ever-healthcare-analytics-summit-and-announces-the-close-of-the-vitalware-acquisition-301125125.htmlSOURCE Health Catalyst.

SALT LAKE zithromax buy canada CITY, Sept. 09, 2020 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst", Nasdaq zithromax buy canada. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Patrick Nelli, Chief Financial Officer, and Adam Brown, Senior Vice President, Investor Relations, will participate in the 2020 Cantor Global Virtual Healthcare Conference on Tuesday, September 15, 2020, which will include a fireside chat presentation at 1:20 p.m. ET.

A live audio webcast and replay of this presentation will be available at https://ir.healthcatalyst.com/investor-relations.About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Investor Relations Contact:Adam BrownSenior Vice President, Investor Relations+1 (855)-309-6800ir@healthcatalyst.comHealth Catalyst Media Contact:Kristen BerryVice President, Public Relations+1 (617) 234-4123+1 (774) 573-0455 (m)kberry@we-worldwide.com Source. Health Catalyst, Inc.SALT LAKE CITY, Sept. 8, 2020 /PRNewswire/ -- Health Catalyst, Inc.

("Health Catalyst," Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that it has completed its seventh annual and first ever virtual Healthcare Analytics Summit (HAS), with record registration of more than 3,500 attendees. Keynotes included Dr. Amy Abernethy, Principal Deputy Commissioner and Acting CIO of the U.S. Food and Drug Administration, Michael Dowling, CEO of Northwell Health, Vice Admiral Raquel Bono, MD, and many others.

Other business updates include:The Vitalware, LLC ("VitalWare"), transaction has closed, and integration is underway of the Yakima, Washington-based provider of revenue workflow optimization and analytics SaaS technology solutions for health organizations. This is another example of Health Catalyst's ability to scale software on top of its cloud-based Data Operating System (DOS™). DOS will further enhance the analytics insights made available by Vitalware's technology by combining charge and revenue data with claims, cost, and quality data. Vitalware's flagship offering is a Best in KLAS chargemaster management solution that delivers results for the complex regulatory and compliance functions needed by all healthcare provider systems. "As announced on August 11, 2020, we entered into an acquisition agreement to acquire Vitalware and expected to close the acquisition in Q3 or Q4 of 2020.

We are pleased to announce that we closed the acquisition on September 1, 2020. We are thrilled to formalize the combination of our solutions for the benefit of our customers and the industry," said CEO Dan Burton. On its upcoming Q3 2020 earnings call, Health Catalyst will share the impact of Vitalware on its Q3 2020 financial performance, which will not be significant given the timing of the acquisition, as well as update its full year 2020 guidance to include the impact of Vitalware. Health Catalyst Co-Founder Steve Barlow has returned from his three-year full-time volunteer mission for the Church of Jesus Christ of Latter-Day Saints, having served as Mission President of the Ecuador Quito Mission. He has rejoined Health Catalyst's companywide Leadership Team as a Senior Vice President, responsible for some of the company's largest customer relationships.

Dan Burton said, "We couldn't be more excited about Steve's return to Health Catalyst. His energy, dedication and commitment to transforming healthcare launched our journey and will continue to make us better and stronger. Steve is leading and overseeing all aspects of our partnerships with some of our largest and longest-standing customers. Steve's extraordinary experience and capability enable him to be a critical partner and leader in enabling these customers' continued improvement and success." "My experience over the past three years in Ecuador reinforced for me how fortunate I am to be in a country with high-quality healthcare," said Barlow. "It has been invigorating to return to Health Catalyst and witness the incredible growth and expansion that has occurred over the past few years.

We are better positioned than ever before to achieve our mission of being the catalyst for massive, measurable, data-informed healthcare improvement. I am grateful to be reunited with our longstanding team members and customers, and I'm thrilled to get to know and work alongside our new customers and teammates in this critical work." Effective October 1, 2020, Chief Technology Officer Dale Sanders will be transitioning to a Senior Advisor role with Health Catalyst, and the company is pleased to announce that one of Dale's longtime protégés and colleagues, Bryan Hinton, will serve as Health Catalyst's next Chief Technology Officer. Hinton joined Health Catalyst in 2012 and currently serves as the Senior Vice President and General Manager of the DOS Platform Business. He will continue to lead this business in addition to assuming the responsibilities of CTO. He has been instrumental in the development and integration of DOS and has been working directly with Dale and other technology leaders at Health Catalyst for many years.

His experience prior to joining Health Catalyst includes four years with the .NET Development Center of Excellence at The Church of Jesus Christ of Latter-Day Saints, where he established the architectural guidance of all .NET projects. Previously, at Intel, he was responsible for the development and implementation of Intel's factory data warehouse product installed at Intel global factories. Hinton graduated from Brigham Young University with a BS in Computer Science. "Dale has been central to Health Catalyst's growth and success and we are grateful to him for his many years of service to our company and to the broader healthcare industry," said Dan Burton, CEO of Health Catalyst. "Thanks to Dale's vision, passion, innovative thinking and broad-based industry experience and perspective, Health Catalyst has grown from a handful of clients to a large number of organizations relying on us as their digital transformation partner, helping the healthcare ecosystem to constantly learn and improve.

Dale's technology leadership was critical to the company's overall maturation, and I am convinced that we could not have grown and scaled as we have without Dale's foundational leadership and contributions. We are grateful to continue our association with Dale in the months and years ahead in his next role as a Senior Advisor to the company." Burton added, "We are thrilled to see Bryan Hinton take on this added role after having demonstrated his technology leadership prowess during the course of his tenure at Health Catalyst and having been mentored by Dale for many years. Bryan is well-prepared and ready for this additional responsibility, and we extend our congratulations to him." "I feel like a parent saying goodbye to my kids at their college graduation," said Dale Sanders. "Many of the concepts we first developed and applied over 20 years ago at Intermountain and then later refined during my tenure as CIO at Northwestern had a big influence on our technology and products at Health Catalyst. The vision of the Data Operating System and its application ecosystem originated in the real-world healthcare operations and research trenches of Northwestern.

At Health Catalyst, I had the wonderful opportunity to lead the teams who made that vision a reality for the benefit of the entire industry. None of it would have been possible without Bryan Hinton leading the DOS team and Eric Just and Dan Unger leading the application development teams. We've been working side-by-side for many years to make the vision real. Bryan is the consummate modern CTO from outside of healthcare that healthcare needs. I've always described Eric as having a manufacturing engineer's mindset with a healthcare data and software engineer's skills, with Dan Unger leveraging his deep domain expertise in financial transformation to oversee the development of meaningful applications and solutions so relevant for CFOs.

I'm honored and thrilled to step aside and turn the future over to their very capable hands. Under their leadership, the best is yet to come for Health Catalyst's technology." About Health CatalystHealth Catalyst is a leading provider of data and analytics technology and services to healthcare organizations, and is committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Health Catalyst Media Contact:Kristen BerrySenior Vice President, Public Relations+1 (617) 234-4123HealthCatalyst@we-worldwide.com View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-completes-hosting-of-the-largest-ever-healthcare-analytics-summit-and-announces-the-close-of-the-vitalware-acquisition-301125125.htmlSOURCE Health Catalyst.