Medicare Advantage

How Medicare Advantage Enrollment Has Grown, Diversified in 10 Years

by Kelsey Waddill

Medicare Advantage enrollment has grown in the last decade largely due to an influx of Black, Hispanic, and low-income beneficiaries, a research letter published in the JAMA Health Forum found. Before...

Medicare Advantage Member Satisfaction Soars, Mental Health Coverage Lags

by Victoria Bailey

Medicare Advantage member satisfaction increased in 2022, but coverage for mental health and substance use disorder services is lagging, according to the JD Power 2022 US Medicare Advantage Study. The...

SCAN Health Plan Announces Medicare Advantage Expansion into TX

by Kelsey Waddill

SCAN Health Plan (SCAN) announced it will be extending Medicare Advantage plans into Texas and new counties in Nevada in 2023. “As SCAN continues to grow and build its national reputation as a...

Cigna Extends Medicare Advantage Transportation Benefit Due to Heat

by Kelsey Waddill

Cigna is expanding its Medicare Advantage transportation benefit to bring Medicare Advantage members to locations where they can avoid the extreme heat. “Older adults tend to be more susceptible...

Medicare Advantage Plans See High Enrollment, Low Spending in 2022

by Kelsey Waddill

Medicare Advantage plans are seeing low healthcare spending, strong diversity, and high enrollment in 2022 compared to 2021 and earlier years, according to the Better Medicare Alliance’s 2022...

Medicare Advantage Plans Increase Profits by Dodging MLR Limitations

by Victoria Bailey

Parent companies that offer Medicare Advantage plans may generate substantial profits through operating related businesses that are not subject to medical loss ratio limitations, according to a report...

Seniors Find Medicare Enrollment Confusing, Avoid Changing Plans

by Kelsey Waddill

Medicare-eligible individuals continue to find original Medicare enrollment processes confusing and may overestimate their healthcare literacy, a report conducted by Sage Growth Partners...

AHIP Calls For More Accurate Federal Reporting on Medicare Advantage

by Kelsey Waddill

AHIP acknowledged the need for improved oversight for certain Medicare Advantage quality metrics but also argued that federal reporting on Medicare Advantage plans has been inaccurate in the...

Medicare Advantage Represents a Growing Share of Medicare Enrollment

by Kelsey Waddill

Medicare Advantage enrollment is on the rise across the United States, with more than 100 congressional districts boasting Medicare Advantage coverage of 50 percent or higher, according to an...

Key Steps to Improve Coverage Integration for Dually Eligible Individuals

by Kelsey Waddill

In its June 2022 report to Congress, MACPAC laid out ways that states can improve the integration of Medicare and Medicaid coverage for dually eligible individuals. “Fully integrated models are...

BMA: MA Member Satisfaction Is High, Prior Authorization Denials Low

by Kelsey Waddill

Medicare Advantage beneficiaries express high levels of member satisfaction, an eHealth survey found. eHealth surveyed nearly 2,850 individuals online toward the end of May 2022. Nearly two-thirds of...

Humana Continues Integrating Home Healthcare Program into Senior Services

by Kelsey Waddill

Humana has announced that it is adding 14 states to its CenterWell Home Health model by continuing to integrate its home healthcare program, Kindred at Home. The payer has been transitioning its...

BMA Supports Bill on Medicare Advantage Prior Authorizations

by Kelsey Waddill

Better Medicare Alliance (BMA) has endorsed HR 3173, the Improving Seniors’ Timely Access to Care Act, a law that seeks to reform prior authorization in Medicare Advantage. “When it comes...

CMS Updates Medicare.gov To Simplify, Support Navigation

by Kelsey Waddill

CMS has updated its website, Medicare.gov, to include new features such as highlighting pages that answer popular questions and spotlighting key steps that consumers should take related to Medicare...

How Payers Can Move Providers Along Value-Based Care Continuum

by Kelsey Waddill

Payers can offer essential support to providers starting their journey through the value-based care continuum, while further research on value-based care in Medicare Advantage can help inform payers about best practices in this...

OIG Suggests Changes to MA Prior Authorizations, Payment Requests

by Kelsey Waddill

Medicare Advantage plans have incorrectly denied or delayed prior authorizations or payment requests and, in doing so, have accrued unwarranted revenues, according to a report from the Office of...

BCBSRI Joins Global Capitation Model, Starts 2022 RI Life Index

by Kelsey Waddill

Blue Cross & Blue Shield of Rhode Island (BCBSRI) has entered into a global capitation agreement in its Medicare Advantage program, according to a press release which HealthPayerIntelligence...

Key Advantages of Medicare Advantage Plans Versus FFS Medicare

by Kelsey Waddill

Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on...

CMS: 2023 Medicare Advantage, Part D Rate Sees 8.5% Revenue Boost

by Kelsey Waddill

CMS announced an 8.5 percent boost on average to payer revenues next year in the 2023 Medicare Advantage and Part D Rate, according to a CMS press release. This final rate announcement was higher than...