Beneficiaries’ Chronic Conditions Did Not Drive MA to FFS Switching Rates
Beneficiaries with multiple chronic conditions did not have higher rates of switching between Medicare Advantage and Medicare fee-for-service (FFS), according to a study published in JAMA. As Medicare...Medicare Advantage Plan Payment Cuts Did Not Impact Enrollment Growth
Medicare Advantage plan payment cuts under the Affordable Care Act (ACA) did not lead to enrollment reductions, suggesting that further payment reform could minimize spending without hurting access to...MedPAC Offers Changes to Medicare Advantage Benefits, Payment Policies
The Medicare Payment Advisory Commission’s (MedPAC) June 2023 report to Congress offered recommendations for addressing disparate Medicare Advantage plan benefits and the future of Medicare...Medicare Advantage Overpayments Expected to Surpass $75B in 2023
Medicare Advantage overpayments may exceed $75 billion in 2023 due to favorable selection of Medicare Advantage plans, data from the USC Schaeffer Center for Health Policy & Economics...Rising Enrollment, Higher Costs Spur Medicare Spending Growth
Rising Medicare enrollment and higher healthcare costs have contributed to significant growth in Medicare spending over the last two decades, according to data from KFF. Medicare provides health...Medicare Advantage Risk Adjustment Model Accuracy May Vary By Race
The CMS-Hierarchical Condition Category (HCC) model used for Medicare Advantage risk adjustment may inaccurately estimate beneficiaries’ spending depending on the race or ethnicity of the...The History of Medicare Advantage: From Inception to Growing Popularity
Medicare Advantage’s popularity continues to grow in 2023 as enrollment figures and plan options increase. The private program has received mixed reviews from healthcare stakeholders, with members generally reporting high plan...Humana Collabs with DME Companies to Advance Value-Based Home Healthcare
Humana has entered value-based agreements with two durable medical equipment organizations to improve home healthcare services for Medicare Advantage members. The organizations, AdaptHealth Corp. and...Humana Seeks to Improve Medicare Advantage Specialty Needs Benefits
Humana has announced a partnership with Longevity Health Plan to improve Medicare Advantage members’ specialty needs plan benefits. Humana’s partner is both a clinical services company and...Medicare Advantage Provider Directories Are Inaccurate, Study Finds
Medicare Advantage provider directories are inaccurate, hindering beneficiaries’ access to mental healthcare, according to a secret shopper survey conducted by the Senate Finance Committee. When...Half of Medicare Beneficiaries Are Enrolled in Medicare Advantage
Half of all Medicare beneficiaries are enrolled in Medicare Advantage, according to the most recent enrollment data from CMS. The CMS data found that, as of January 2023, 30.19 million of the 59.82...Medicare Advantage, Part D Premiums Increased Slightly in 2023
Average monthly premiums for Medicare Advantage and Part D plans have increased in 2023, and fewer beneficiaries selected zero-dollar premium plans, a report from eHealth, Inc. found. eHealth’s...3 Ways Payers Can Employ Machine Learning, Advanced Analytics
MVP Health Care (MVP) has been piloting machine learning and advanced analytics solutions and, in the process, explored three key uses for these types of tools. Machine learning falls under the umbrella of artificial intelligence tools....Younger Medicare Beneficiaries Report More Issues with Care Access, Costs
Medicare beneficiaries under age 65 reported more cost concerns, worse access to care, and lower care satisfaction compared to older beneficiaries, indicating that the program may not successfully meet...Sponsored Article
