CalOptima—a county-organized health system that offers care through public payer coverage, including Medicaid, Medicare Advantage, and Medicare-Medicaid plans—is launching a five-year...
Payers cannot ignore the crucial role that caregivers play in members’ health, wellness, and recovery, and should consider supporting caregivers through Medicare Advantage caregiver benefits, especially in special needs...
MedPAC’s March 2022 recommendations to Congress for Medicare Advantage payment policies have roused reactions from payers, specifically Better Medicare Alliance.
At the beginning of the report...
Payer organizations such as AHIP and the Alliance for Community Health Plans (ACHP) have raised some concerns in their comments on the advance notice of methodological changes for Medicare Advantage...
Medicare Advantage plans expanded their supplemental benefits offerings in 2022, with more health plans offering special supplemental benefits for the chronically ill (SSBCI), according to an issue...
Humana is transitioning its Kindred at Home home healthcare products to the CenterWell Home Health brand.
The transition entails apparel and other branded material changes from Kindred at Home...
Medicare beneficiaries are experiencing healthcare affordability challenges in 2022 due to Medicare Part B premiums and inflation, according to a MedicarePlans.com survey.
Pollfish surveyed 1,250...
AHIP supported CMS on its national coverage determination for monoclonal antibodies (mAbs) directed against amyloid for treating Alzheimer’s Disease and offered recommendations for clarification...
The CMS post-acute care transfer (PACT) policy and the use of home healthcare helped reduce hospital readmissions for recently discharged patients and lower hospital expenditures, according to a study...
Medicare beneficiaries with high health insurance literacy were more likely to enroll in Medicare Advantage and select low-cost plans with high Medicare Advantage star ratings, compared to those with...
Major payers have released their earnings reports from the fourth quarter of 2021, which revealed the continued impacts of the coronavirus pandemic, highlighted mergers and acquisitions deals, and made...
In the 2023 Medicare Advantage and Part D Advance Notice, CMS is requesting comments on the agency’s health equity index which it seeks to introduce into Part D and Medicare Advantage Star...
More than 340 members of the US House of Representatives have penned a letter to CMS asking the agency to continue to uphold Medicare Advantage benefits, including stable premium rates and supplemental...
Payers can leverage beneficiary surveys, opportunities to share lessons learned, and social services referral platform data in order to assess the return on investment for social determinants of health...
CMS released the calendar year 2023 Medicare Advantage and Part D proposed rule which aims to improve network adequacy, elucidate medical loss ratio reporting, open the possibility of assigning star...
The share of denied claims in Medicare is largely attributable to laboratories, according to a study published in Health Affairs.
Researchers worked with Aetna and Medicare data to assess the number...
Humana has partnered with Vancouver Clinic to expand value-based primary care services to Medicare Advantage members in Oregon.
The primary care practice, Enliven by Vancouver Clinic, will be...
The majority of Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) are enrolled in fee-for-service Medicare, but the share of beneficiaries in Medicare Advantage plans is...
The Medicare Advantage quality bonus program did not lead to any significant improvements in overall performance quality for Medicare Advantage plans, a Health Affairs report found.
CMS introduced the...
Dual eligible beneficiaries were more likely to choose a Medicare Advantage plan over a fee-for-service Medicare plan, a study commissioned by Better Medicare Alliance (BMA) found.
To understand the...
