October 11, 2024
Negative Tone Confirmed for CY25 Medicare Advantage Stars and Beyond as Goalposts Continue to Move
Key Takeaways: As we expected, CMS’s release of the CY25 Medicare Advantage (MA)/Part D star ratings continues to limit program “largesse,” making bonus awards more selective and ratings harder to maintain YoY. For CY25, fewer…
October 10, 2024
Potential Top Officials in a Harris Administration
With our view that the odds slightly favor Vice President Kamala Harris winning the presidency in November (see here), we offer a comprehensive list of potential candidates for key Cabinet and other important positions below. …
October 9, 2024
Harris’ In-Home Care, Vision, Hearing Aid Medicare Coverage Proposal – Likely an Undelivered Promise
We are skeptical of enactment for Vice President Kamala Harris’ campaign proposal to add a Medicare in-home care benefit, along with vision and hearing aid coverage, even if she were to win (our base case)…
October 9, 2024
Exact Sciences (EXAS): Rate Reversal Prospects
Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…
October 9, 2024
Exact Sciences (EXAS): Rate Reversal Prospects
Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…
October 8, 2024
[EW, ABT] Tricuspid Coverage & Sales Trajectory
Key Takeaways: As investors look to model out sales of Edwards Lifesciences’ (EW) Evoque tricuspid valve replacement in advance of CMS’s draft National Coverage Determination (NCD), which is expected by ~Dec. 20 (final policy due…
October 8, 2024
Negative Tone Ahead for Medicare Advantage Stars While Awaiting CY25 Awards
Key Takeaways: Developments involving Humana (HUM) and UnitedHealth (UNH) last week show CMS remains intent on limiting the financial “largesse” insurers receive in its Medicare Advantage (MA)/Part D (PDP) star rating quality bonus program by…
October 8, 2024
Slight Advantage for Harris
With less than a month until Election Day, we view Vice President Kamala Harris as having a slight edge over Donald Trump. The House is likely to be controlled by whichever party wins the presidency,…
October 8, 2024
Highway Spending Projections
Late last Friday, the Congressional Budget Office’s (CBO) released a report titled, “Baseline Projections for the Highway Trust Fund Accounts”, detailing estimated spending for highways and transit through 2034. We have attached the report here…