Updated 11/10/21: This article has been updated to elucidate the differences between Medicare Advantage beneficiaries' and fee-for-service Medicare beneficiaries' use of telehealth and...
As the 2022 Medicare Advantage open enrollment period approaches, payers are revealing their 2022 Medicare Advantage benefits.
Five major payers shared the updates to their benefit offerings for the...
Updated 9/30/21: This article has been updated to include a correction from Better Medicare Alliance. A previous version read "we urge lawmakers to project these gains," but this has been...
Some Medicare Advantage plans may have improperly used chart reviews and health risk assessments to maximize risk-adjusted payments from CMS, a report from the Office of Inspector General...
Black beneficiaries are less likely to live in counties with a high enough Medicare Advantage quality performance to be eligible for Medicare Advantage double bonus payments, a Health Affairs report...
Social determinants of health contracting with community-based organizations remains a complex and challenging task for payers as the demand for answers grows more pressing.
As the industry’s...
Policymakers are looking to include dental, hearing, and vision benefits to Medicare as a part of the budget reconciliation bill, which could benefit many Medicare beneficiaries who go without this...
Better Medicare Alliance has commended Congress for including additional benefits in its proposed Budget Reconciliation plan for Medicare reform and is urging lawmakers to maintain the structure that...
Updated 9/13/21: This article has been updated to reflect that AHIP has taken a stance regarding the potential outcomes if the proposed policy passes. A previous version of the article incorrectly...
SCAN Health Plan is expanding its Medicare Advantage footprint to Arizona, Nevada, and additional counties in California to reach more than five million senior beneficiaries.
SCAN currently provides...
Omnichannel strategies are becoming increasingly significant to successful member engagement.
What is omnichannel engagement? Omnichannel engagement is a strategy that originated as a sales and...
Wellcare has announced that Centene and Wellcare will consolidate their Medicare offerings under the Wellcare brand name.
This strategy will bring Centene Medicare products like Allwell, Health...
Updated 8/30/2021: The original AHIP analysis was corrected to convey that seniors could lose at least $696 in Medicare Advantage benefits. This article has been altered to include that...
CMS has requested that Medicare Advantage organizations relax or waive prior authorizations due to the impact of the coronavirus Delta variant.
“The ability of hospitals to transfer patients to...
Escalations in Medicare Advantage healthcare spending—along with higher traditional Medicare spending—could drive scarcity in the Medicare hospital insurance trust fund and could boost...
The Alliance of Community Health Plans (ACHP) voiced its support for the Quality Payment Relief Act, which the organization argued would correct the use of Medicare Advantage benchmark caps and enable...
The way to determine the quality of a Medicare Advantage health plan is simple: look at the five-star rating on the Medicare website. However, the Medicare Advantage Star Rating methodology that...
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...
The Department of Justice (DOJ) will intervene in the case of six whistleblower lawsuits against Kaiser Permanente regarding Medicare Advantage diagnosis codes and alleged Medicare fraud.
The lawsuits...
Anthem Blue Cross and Blue Shield (Anthem) and Kroger Health have announced that they will be partnering to offer a Medicare Advantage plan in 2022, an Anthem spokesperson told HealthPayerIntelligence...
