Gathering social determinants of health data continues to be a challenge for Medicare Advantage health plans, according to a report that NORC at the University of Chicago (NORC) compiled for Better...
Aetna is expanding its existing Medicare-Medicaid Alignment Initiative (MMAI) plan to provide coverage for all dual eligibles in Illinois.
Since March 2014, the MMAI has been providing coordinated...
Medicare Advantage dual eligibles reported better access to care and access to telehealth during the coronavirus pandemic than traditional Medicare beneficiaries did, a report from NORC at the...
Dual eligible beneficiaries—individuals who are eligible for both Medicaid and Medicare benefits—still experience challenges navigating the two programs and would benefit from an integrated...
In the first six months of 2020, fee-for-service Medicare utilization dropped across categories of services, races, and dual eligibility statuses, a recent Avalere study confirmed.
Avalere researchers...
Dual eligibles with end-stage renal disease (ESRD) differ from non-duals in demographic factors as well as healthcare spending characteristics, but their healthcare utilization rates are the same as...
Molina Healthcare, Inc. announced that it will acquire Magellan Complete Care from Magellan Health, Inc. on April 30, 2020.
“We believe it will allow us to scale our enterprise-wide platforms...
Medicaid expansion is key to securing national access to care for the new coronavirus and the federal government can and should support state programs for increasing COVID-19 coverage, according...
Dual eligible beneficiaries who are in “aligned enrollment”—or are enrolled in both a dual eligible special needs plan and a Medicaid managed care organization under the same...
CMS has issued guidance that will help states avoid pursuing a duplicate discount from manufacturers when submitting state Medicaid rebate requests.
“Manufacturers are not required to both...
CMS efforts to empower Medicare Advantage plans to tackle social determinants of health (SDOH) led mainly to the expansion of existing benefits but not the addition of new benefits, stakeholders told...
Enrollment of dual eligible individuals in Medicare Advantage (MA) has been “lagging” even with MA numbers projected to hit 70 percent between 2030 and 2040, according to a recent analysis...
Over half of dual-eligible Medicare Advantage beneficiaries experience the social determinants of health, revealing a need for better social health programming within the program, according to data...
People who choose to enroll in Medicare Advantage plans have lower average spending before enrolling in these plans than beneficiaries who choose to stay in traditional Medicare, according to a report...
CMS has issued a letter to state Medicaid directors inviting them to test new, integrated care models for individuals dually eligible for Medicare and Medicaid.
There are 12 million dual eligible...
Medicaid beneficiaries with serious mental illness (SMI) or serious emotional disturbance (SED) are the targets of recent CMS efforts to improve health outcomes.
In a letter to Medicaid directors...
Medicare and Medicaid dual-eligible care models provide extensive care coordination to ensure beneficiaries with multiple chronic conditions can access healthcare services, according to a new AHIP...
Congress should consider a permanent renewal of the Medicare Advantage Special Needs Plans (SNPs) because of the consumer protections they provide and their market implications, AHIP wrote in a letter...
A recent Harvard Chan School of Public Health analysis found that Medicaid beneficiaries are overwhelmingly satisfied with their coverage and access to providers. The nationwide survey of more...
As state and federal regulators debate the future of Medicaid spending, health researchers have identified the need for flexibility and innovation in Medicaid policies involving payment models,...
