Medicare Advantage

Payers react to 2025 Medicare Advantage, Part D Final Rates

April 10, 2024 - Payer trade organizations responded negatively to the 2025 Medicare Advantage and Part D Final Rate Notice, citing rising healthcare costs. “The CMS Final Rate Notice failed to address the concerns of influential bipartisan Members of Congress, thousands of Medicare Advantage beneficiaries, and more than one hundred organizations serving...

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How are Medicare plans lowering drug costs for beneficiaries?

by Victoria Bailey

Affordable access to prescription drugs is a necessity for managing chronic and acute conditions and staying healthy. However, as drug costs rise, both affordability and accessibility are dwindling. Over 80 percent of surveyed adults said...

Medicare Advantage final rule addresses competition and marketing practices

by Victoria Bailey

CMS has finalized policies to promote competition in Medicare Advantage and Part D plans, boost access to behavioral healthcare services, and reduce deceptive marketing practices. The Contract Year...

Humana and Baptist Health reach contract agreement for in-network coverage

by Victoria Bailey

Kentucky-based Baptist Health Medical Group and Humana have reached a new contract agreement, restoring in-network coverage for Medicare Advantage and commercial patients. The multi-year agreement...

Wellcare partners with tech company to improve value-based primary care

by Victoria Bailey

Wellcare, the Medicare brand of Centene Corporation, has partnered with a technology company to improve access to value-based primary care. The company, Pearl Health, focuses on physician enablement...

2024 Medicare Advantage premiums remain low and stable

by Victoria Bailey

The average Medicare Advantage premium has remained low and stable, with many beneficiaries choosing plans with a zero-dollar monthly premium, according to data from eHealth, Inc. eHealth’s...

Medicare Advantage enrollment increased by 1.7 million beneficiaries

by Victoria Bailey

Medicare Advantage enrollment has increased by 1.7 million beneficiaries since 2023, with for-profit health plans dominating the market, a Chartis report revealed. Among 65.9 million Medicare-eligible...

With Proper Use, Artificial Intelligence Improves Health Plan Operations

by Victoria Bailey

While artificial intelligence is far from a new concept, the healthcare industry has recently latched on to the technology, leading to increased adoption across many sectors. Artificial intelligence has the potential to lower healthcare...

Medicare Advantage Beneficiaries Receive Less Home Healthcare Services

by Victoria Bailey

Medicare Advantage beneficiaries received shorter and less intensive home healthcare services than those in traditional Medicare, a study published in JAMA Health Forum found. The Medicare home...

MA Payment Reductions May Impact Value of Healthcare for Beneficiaries

by Victoria Bailey

The proposed 2025 Medicare Advantage Advance Notice would impact the value of healthcare for beneficiaries, resulting in higher costs, according to an analysis from the Berkeley Research Group...

Care Access, Coverage Value Similar in Medicare Advantage and Medicare

by Victoria Bailey

Coverage and care experiences were generally similar for Medicare Advantage and traditional Medicare beneficiaries, but instances of care delays and health assessments differed, a survey from the...

Dental Coverage in Medicare Advantage Plans Varies by Demographic

by Victoria Bailey

Almost a third of beneficiaries had a Medicare Advantage plan that didn’t offer dental coverage in 2019, but coverage was more common among historically underserved populations, a study published...

Medicare Advantage Intake Surveys May Draw Insights, But Not Always

by Kelsey Waddill

New Medicare Advantage plan members can self-report their health literacy status during the enrollment process, but may not be as responsive in an enrollment survey of perceived healthcare...

What Is Behind Rampant Medicare Advantage Contract Terminations?

by Victoria Bailey

With a history of overpayments, care denials, and limited provider networks, the relationship between Medicare Advantage and the rest of the healthcare industry has always been tumultuous. Over the past year, the private payer program has...

HCSC Announces $3.3B Cigna Medicare Business Acquisition

by Kelsey Waddill

HCSC, an independent licensee of the Blue Cross Blue Shield Association, intends to seal the acquisition of Cigna’s Medicare businesses for $3.3 billion, the payer announced. The purchase...

Lawmakers Lobby for Payment and Policy Stability in Medicare Advantage

by Victoria Bailey

A bipartisan group of United States Senators has urged CMS to ensure payment and policy stability in Medicare Advantage as the agency considers program updates for 2025. The letter to CMS...

CMS Proposes 3.7% Increase in Medicare Advantage Plan Payments

by Victoria Bailey

Medicare Advantage plan payments will increase by 3.7 percent or $16 billion in 2025, CMS proposed in the Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage and Medicare Part D...

HHS Seeks Stakeholder Input to Improve Medicare Advantage Transparency

by Victoria Bailey

HHS has issued a request for information (RFI) to help improve data-sharing and transparency in the Medicare Advantage. Over half of all Medicare beneficiaries are enrolled in Medicare Advantage,...

UnitedHealth Group Saw Revenue and Enrollment Growth in 2023

by Victoria Bailey

UnitedHealth Group saw revenue growth of over 14 percent in 2023, while adding 1.7 million new consumers to its Medicare and commercial offerings, executives shared during the UnitedHealth Group Fourth...

Underserved MA Beneficiaries Opt for Plans with Supplemental Benefits

by Victoria Bailey

Black Medicare Advantage beneficiaries and those with lower income or educational attainment were more likely to choose health plans that include supplement benefits, such as dental and vision...

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