Patient Outcomes

Does Integrating Medicare and Medicaid Improve Care for Dual Eligibles?

December 28, 2023 - Integrating Medicare and Medicaid coverage for dual eligible beneficiaries was associated with higher use of home- and community-based services (HCBS) but did not reduce hospitalization or improve care coordination, a study published in JAMA Health Forum found. Beneficiaries eligible for both Medicare and Medicaid tend to have complex care needs...


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How Employers Can Promote Cardiovascular Care, Women’s Health

by Kelsey Waddill

Cardiovascular, diabetes, and obesity treatments are a critical part of women’s health, and employers can take steps to ensure that women have access to information and care related to their...

Humana’s Value-Based Care Plans Improved Health Outcomes for MA Members

by Victoria Bailey

Humana Medicare Advantage beneficiaries receiving care under value-based arrangements had better health outcomes, including fewer inpatient admissions and emergency room visits, a report from the payer...

Care Quality, Health Outcomes Better in Medicare Advantage than FFS

by Victoria Bailey

Medicare Advantage beneficiaries experience higher quality care and better health outcomes than fee-for-service beneficiaries, according to a report from Harvard and Inovalon. Researchers used...

How One MA Plan Prioritized SDOH to Improve Diabetes Care Access

by Victoria Bailey

Health plans must look beyond clinical outcomes and address social determinants of health to improve beneficiaries’ health. Zing Health, an Illinois-based Medicare Advantage plan, did just that for beneficiaries living with...

Healthcare Spending Lower in MA for Beneficiaries with Chronic Conditions

by Victoria Bailey

Medicare Advantage beneficiaries with chronic conditions had lower healthcare spending and fewer emergency room visits than fee-for-service (FFS) beneficiaries, according to a report from Avalere...

How Long-Term Health Plan Enrollment Supports Value-Based Care

by Victoria Bailey

Realizing value-based care success is easier said than done. While a primary goal of value-based care is to improve long-term health outcomes and costs, that can be difficult when consumers’ healthcare journeys are disrupted each...

Cash Payments Could Help Medicaid Beneficiaries Obtain Better Coverage

by Kelsey Waddill

Cash payments that phase out based on income could allow Medicaid beneficiaries to shift away from low-quality care under safety net healthcare coverage to higher-quality care through private payer...

CareSource Enters Value-Based Agreement to Improve Pediatric Health Outcomes

by Victoria Bailey

CareSource has entered into a value-based agreement with a clinically integrated network to improve pediatric health outcomes for Georgians. The partnership between the health plan and The...

58% of Payers Use Outcomes-Based Contracts for Prescription Drugs

by Victoria Bailey

More than half of payers used an outcomes-based contract in 2022, with most preferring contracts with both claims-based and clinical outcomes, an Avalere survey found. The online survey was conducted...

Community Health Centers Seek Enrollment Support Amid Medicaid Redeterminations

by Kelsey Waddill

Community health centers serve the communities that are most likely to experience widespread coverage loss once Medicaid redeterminations are underway and they are looking for help in maintaining...

Medicaid Expansion Tied to Reduced Postpartum Hospitalizations

by Victoria Bailey

Medicaid expansion was associated with a reduction in postpartum hospitalizations during the first six months after delivery, according to a Health Affairs study. Federal policy requires Medicaid to...

Medicare Advantage Beneficiaries Have Better Diabetes Patient Outcomes

by Kelsey Waddill

Medicare Advantage plans have seen better patient outcomes in chronic disease management for diabetes than fee-for-service Medicare, according to a study by Avalere. “Medicare Advantage is...

Heat-Related Illness Diagnoses Among Private Payer Members Are Increasing

by Kelsey Waddill

Privately-insured Americans experienced higher rates of heat-related illness diagnoses in 2021 compared to 2016, in some cases a more than 37 percent increase, according to a report from FAIR...

Top 3 Major Trends in National Health Outcomes Measures

by Kelsey Waddill

Overall, major health outcomes measures are trending in a negative direction, according to America’s Health Rankings Annual Report for 2022. The Annual Report examines 23 measures to assess...

Health Insurance Coverage Disruptions Tied to Higher Mortality Risks

by Victoria Bailey

Health insurance coverage disruptions were associated with higher mortality risks for people with private and public insurance, a JAMA Health Forum study found. Health insurance coverage is typically...

Medicaid Expansion Reduced Medicare Hospitalizations During Dialysis

by Victoria Bailey

Medicaid expansion may help minimize Medicare spending, as it was associated with reduced hospitalizations and hospital days for Medicare beneficiaries with kidney failure who initiated dialysis, a...

Payers Leverage Technology to Boost Maternal Health Outcomes

by Sarai Rodriguez

Payers are implementing new programs that capitalize on telehealth and partnerships with technology companies to better engage pregnant members and improve maternal health outcomes. There has been an...

Payer Fuses Family, Maternal Care Through Virtual Care, Care Management

by Kelsey Waddill

Blue Cross Blue Shield of Michigan and Blue Care Network have partnered with Maven Clinic to combine family-building and maternal care support through virtual care and care management...

Healthcare Often Forces Patients to Make Financial Sacrifices

by Mark Melchionna

Many American adults make personal financial sacrifices and miss appointments to cope with the high costs of healthcare, according to a West Health-Gallup Poll.. Due to high and consistent costs,...