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The population on the Affordable Care Act’s (ACA's) exchanges that do not get subsidies declined by 45% from 2016 to 2019, a new report from the Trump administration found. The report, released Friday (PDF) from the Centers for Medicare & Medicaid Services (CMS), argues that people who don’t qualify for income-based subsidies to lower the cost of insurance are being priced out of the exchanges. (King, 10/9)

The Center for Medicare & Medicaid Innovation designed its direct-contracting program to attract providers that didn’t take part in its accountable care models. Experts predicted the model’s financial terms would entice new provider organizations. The Medicare Shared Savings Program “had a core problem: If you did not have an established patient base, you could not be an ACO,” said former CMS official Travis Broome, now senior vice president for policy and economics at consulting firm Aledade. Direct contracting appears to solve that problem. (Brady, 10/10)

Fewer Medicare Advantage plans scored high quality ratings for their 2021 plans than the year before, according to the latest federal data. Of the 400 Advantage plans with prescription drug coverage that received a rating, roughly 49% earned four stars or higher on a scale of one to five stars, with five being the highest. For 2020 plans, 52% scored four stars or more. (Livingston, 10/9)