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Jose Figueroa, MD, MPH @joefigs.bsky.social · 15d

Three key findings:

1. In just 1yr, we saw a ~55% enrollment growth among full-benefit duals and >68% among partial duals into C-SNPs.

2. About 1 in 4 duals in 2025 C-SNPs came from plans w/ some form of integration.

3. About 15% of C-SNPs could be terminated if CMS applied “look-alike” rule

Jose Figueroa, MD, MPH @joefigs.bsky.social · 15d

In new #HealthAffairs Forefront piece, we show a troubling trend:

Rapid growth of “Chronic Condition Special Needs Plans (C-SNPs)” enrolling dual-eligibles.

We argue their growth is threatening national integrated care efforts for duals.

www.healthaffairs.org/do/10.1377/f...

Growth Of C-SNPs May Be Jeopardizing Medicare-Medicaid Integration | Health Affairs Forefront

With the new availability of Medicare enrollment data for 2025, we examine ongoing enrollment growth of chronic condition special needs plans (C-SNPs) overall and among the dual-eligible population.

www.healthaffairs.org

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Jose Figueroa, MD, MPH @joefigs.bsky.social · 18d

Federal funding reportedly sent to Harvard for about 200 grants totaling $46 million.

Some welcome relief hopefully to so many.

Story below:

www.thecrimson.com/article/2025...

Harvard Receives $46 Million in Federal Grants, Ending 4-Month Freeze | News | The Harvard Crimson

Millions of dollars in federal research grants from the National Institutes of Health began to flow to Harvard on Friday, the first grant money to return to the University since a judge struck down th...

www.thecrimson.com

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Reposted by Jose Figueroa, MD, MPH

JAMA Health Forum @jamahealthforum.com · 23d

Viewpoint: #Medicaid is vital for low-income, dual-eligible adults and people with disabilities, but coverage disruptions due to administrative barriers increase health risks. ja.ma/4pBxGUO

JAMA Health Forum viewpoint: "Mitigating the Dangers of Medicaid Churn Among Dual-Eligible Beneficiaries" by Eric T. Roberts and José F. Figueroa, published online September 12, 2025.

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Jose Figueroa, MD, MPH @joefigs.bsky.social · Jul 29

Sign of a broken health care system when patients with cancer feel like this:

“I always told myself the stress of dealing with insurance was worse than the cancer.”

Insights from patients w/ cancer dealing with prior authorizations in @jamanetworkopen.com study

jamanetwork.com/journals/jam...

Patient Perspectives on Prior Authorization for Cancer Care

This qualitative study characterizes the perspectives of patients with cancer regarding their experience with prior authorization for cancer care.

jamanetwork.com

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Jose Figueroa, MD, MPH @joefigs.bsky.social · Jul 1

The true cost of the reconciliation bill will be measured in lives—over 50,000 per year.

It’s a predictable result when you cut off insurance to people who are old, poor and sick.

Eric Roberts @pennldi.bsky.social and I discuss @msnbc.com @harvardhpm.bsky.social

www.msnbc.com/opinion/msnb...

Opinion | The true cost of the GOP’s megabill will be measured in lives. Tens of thousands of lives.

It’s a predictable result when you cut off health insurance to people who are old, poor and sick.

www.msnbc.com

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Jose Figueroa, MD, MPH @joefigs.bsky.social · Jun 24

Promising development in Congress:

A bipartisan group of House and Senate lawmakers considering finally fixing the MA to VA cost-shifting loophole that currently leads to billions in MA profits to provide zero care while VA foots the bill.

Story by @wsj.com

www.wsj.com/politics/pol...

Exclusive | Lawmakers Seek to Close VA Loophole That Funnels Billions to Private Medicare Insurers

A Wall Street Journal investigation found the federal government paid insurers an estimated $44 billion from 2018 through 2021 to cover veterans in Medicare Advantage plans who were also getting healt...

www.wsj.com

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Jose Figueroa, MD, MPH @joefigs.bsky.social · Jun 12

Our new @JAMAHealthForum study adds more evidence on how Medicare Advantage plans enrolling veterans are maximizing profits by not paying for care.

Veterans in high-veteran MA plans are much more likely to have surgical care paid by VA than plan itself—even when surgery occurs in non-VA hospitals…

JAMA Health Forum @jamahealthforum.com · Jun 9

Veterans enrolled in high-veteran Medicare Advantage plans are more likely to have their surgical care costs shifted to the Veterans Health Administration instead of being covered by the MA plans.

#ARM25 @academyhealth.bsky.social

https://ja.ma/4jKGy6e

Figure 1. Adjusted Inpatient Surgery Payment Sources for Veterans Health Administration Enrollees in High Veteran MA Plans vs. Other Medicare Advantage Plans, 2021

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Jose Figueroa, MD, MPH @joefigs.bsky.social · Jun 6

I’m honored and excited to have been selected as one of the 2025 Aspen Ideas Health Fellows this year!

Forum brings together a diverse set of people working on issues related to improving health.

Full list of @aspenideas.bsky.social Health Fellows:

www.aspenideas.org/articles/202...

2025 Aspen Ideas: Health Fellows | Aspen Ideas

The Aspen Ideas: Health Fellows are a diverse group of health leaders who are selected for their innovative work, inspired accomplishments, and ability to transform ideas into action. Get to know the ...

www.aspenideas.org

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Reposted by Jose Figueroa, MD, MPH

Adrianna McIntyre @adrianna.bsky.social · May 24

I want to emphasize that this is 18,000 avoidable deaths per year *of Medicare enrollees.*

They aren't in CBO's "uninsured" count — they're older people and folks with disabilities on Medicare who won't get extra financial help because of a proposed moratorium on a regulation.

Jose Figueroa, MD, MPH @joefigs.bsky.social · May 24

CBO projects that House reconciliation bill will cause 1.38 million low-income Medicare beneficiaries to lose Medicaid coverage

We estimate that this will lead to over 18,000 avoidable deaths per year stemming from loss of drug subsidies

Link to our memo led by @pennldi.bsky.social:
bit.ly/4mwfcDA

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 24

Estimates are based on our recent @nejm.org study showing that loss of subsidized coverage (the Part D Low-Income Subsidy) led to significant increases in mortality among low-income Medicare beneficiaries.

@pennldi.bsky.social @harvardhpm.bsky.social

Link to study: www.nejm.org/doi/full/10....

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM

A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

www.nejm.org

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 24

CBO projects that House reconciliation bill will cause 1.38 million low-income Medicare beneficiaries to lose Medicaid coverage

We estimate that this will lead to over 18,000 avoidable deaths per year stemming from loss of drug subsidies

Link to our memo led by @pennldi.bsky.social:
bit.ly/4mwfcDA

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 21

Last week was hard for us @hsph.harvard.edu after losing all NIH grants.

This week, we are forced to reckon with what’s next, including shutting down research portfolios, considering staffing cuts, and scrambling to cover salaries.

HSPH: “ground zero” of NIH cuts

www.nytimes.com/2025/05/21/u...

Federal Cuts Become ‘All Consuming’ at Harvard’s Public Health School

www.nytimes.com

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 21

Link to study 1: www.nber.org/papers/w33719

Link to study 2, which is our @nejm.org study led by Eric Roberts: www.nejm.org/doi/full/10....

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM

A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

www.nejm.org

Jose Figueroa, MD, MPH @joefigs.bsky.social · May 21

Great summary of 2 recent studies in @npr.org by @lesliemwalker.bsky.social that show:

1) Value of having Medicaid (Wyse & Meyer, NBER)

2) Human costs of losing Medicaid & linked subsidized drug coverage in @nejm.org

Lives saved in study 1 and lives lost in study 2

www.npr.org/sections/sho...

New studies show what's at stake if Medicaid is scaled back

Researchers studied the health care program's effect on the health of millions of Americans and found tens of thousands of lives were saved.

www.npr.org

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Reposted by Jose Figueroa, MD, MPH

JAMA @jama.com · May 15

Veterans in Medicare Advantage and Traditional Medicare used dental and vision services at similar rates, with no significant difference in total spending. #SGIM25

https://ja.ma/3ZficKj

Table 1. Characteristics of Veterans With Medicare Advantage
vs Traditional Medicare, 2018-2021

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 16

Taken together, the comprehensive CMS payments MA plans get to care for vets (especially those who get little to no medical care paid by MA) are simply not justified by the “extra” MA supplemental benefits.

Urgent need for VA and CMS to fix this inefficiency to tune of $BILLIONS per year.

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 16

Using national survey data, we find:

1. No significant differences in total utilization or spending of dental & vision services between vets in MA vs TM.

2. MA plans only spend ~$82 per veteran enrollee on dental care and ~$6 more on vision aids than what TM vets get.

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 16

Many veterans enrolling in Medicare Advantage get zero care paid by plans.

MA insurers argue that vets get extra benefits (vision + dental).

But in new @jama.com study, we find that this claim is NOT actually the truth.

@adambeckman.bsky.social @hsph.harvard.edu

jamanetwork.com/journals/jam...

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Reposted by Jose Figueroa, MD, MPH

Ellen Meara @ermeara.bsky.social · May 15

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | New England Journal of Medicine www.nejm.org/doi/full/10....
How important is help with drug costs? For dual Medicare-Medicaid beneficiaries, it saves lives.

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM

A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

www.nejm.org

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Reposted by Jose Figueroa, MD, MPH

Adrianna McIntyre @adrianna.bsky.social · May 14

As @lesliemwalker.bsky.social writes for Tradeoffs today, discussing the paper’s findings, that regulation “was poised to help nearly 1 million more duals gain this extra medication assistance, but the latest Republican proposal delays that rule until 2035.”

Tradeoffs: How Cutting Medicaid Could be Deadly

Two new research papers add important data to the fierce political debate over Medicaid in Washington, D.C. Both offer strong evidence that Medicaid, the public insurance program that covers more than...

mailchi.mp

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Reposted by Jose Figueroa, MD, MPH

Adrianna McIntyre @adrianna.bsky.social · May 14

Talk about some timely research.

Here's the punchline: "Loss of drug subsidies after Medicaid disenrollment was associated with higher mortality among low-income Medicare beneficiaries."

www.nejm.org/doi/full/10....

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Reposted by Jose Figueroa, MD, MPH

Aaron Schwartz @aschwartz.bsky.social · May 14

Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.

Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM

A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

www.nejm.org

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Reposted by Jose Figueroa, MD, MPH

Adrianna McIntyre @adrianna.bsky.social · May 2

The White House's "skinny budget" clarifies that they are, indeed, proposing to end all new extramural AHRQ funding while folding it into ASPE. www.whitehouse.gov/wp-content/u...

(Standard disclaimer that AHRQ is an agency created and funded by Congress, not at the whims of the executive branch)

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Jose Figueroa, MD, MPH @joefigs.bsky.social · May 2

This progress, however, is currently at threat with recent cuts to HIV programs.

hsph.harvard.edu/news/hiv-car...

HIV care quality has been improving for older adults | Harvard T.H. Chan School of Public Health

More people living with HIV and enrolled in Medicare are taking modern, less toxic antiretroviral drugs than ever before, according to a new study led by Harvard Chan School. This progress may be upen...

hsph.harvard.edu