Quality Of Care

Medicare Hospice Model Improved Quality of Life, Reduced Medicare Spending

November 30, 2023 - The Medicare Care Choices Model (MCCM) improved end-of-life care, increased hospice use, and reduced inpatient admissions for Medicare beneficiaries while simultaneously lowering Medicare spending, a study published in Health Affairs found. Beneficiaries can receive palliative care through the Medicare hospice benefit, but when choosing that route,...


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Care Quality, Health Outcomes Better in Medicare Advantage than FFS

by Victoria Bailey

Medicare Advantage beneficiaries experience higher quality care and better health outcomes than fee-for-service beneficiaries, according to a report from Harvard and Inovalon. Researchers used...

Medicare Advantage Star Ratings Fall for Second Consecutive Year

by Victoria Bailey

The average star ratings for Medicare Advantage and Medicare Part D prescription drug plans fell for the second year in a row to 4.04 and 3.11 stars, respectively, CMS data revealed. The star rating...

Cash Payments Could Help Medicaid Beneficiaries Obtain Better Coverage

by Kelsey Waddill

Cash payments that phase out based on income could allow Medicaid beneficiaries to shift away from low-quality care under safety net healthcare coverage to higher-quality care through private payer...

Payers Fall Short of Employer Expectations on Behavioral Healthcare

by Kelsey Waddill

Employers agree that behavioral healthcare is a critical element of employer-sponsored health plan benefits, but more than three in ten found their payer’s behavioral healthcare benefits...

How 2023 Medicare Advantage Enrollment Growth Has Shifted

by Victoria Bailey

This article was originally published on 2/22/23. It has been updated to reflect corrected data from Chartis and CMS. Medicare Advantage enrollment has increased by 2.7 million beneficiaries in 2023...

Medicare Advantage Has Lower Healthcare Use, Higher Clinical Quality

by Victoria Bailey

Healthcare utilization was lower in Medicare Advantage compared to traditional Medicare, but clinical quality performance was higher in the private program, a study published in Health Affairs...

MedPAC Calls on Congress to Modify Medicare Advantage Payment Policies

by Victoria Bailey

As Medicare Advantage enrollment grows, the Medicare Payment Advisory Commission (MedPAC) is calling on Congress to address payment and coding differences between Medicare Advantage and Medicare...

Employers Emphasize Quality of Care When Assessing Health Plans

by Kelsey Waddill

Two big shifts occurred among employers between 2020 and 2022: more employers reported that their health plans shared safety and quality of care data and more employers did not find their health...

Elevance Health Will Acquire BCBSLA, Improve Care Access in LA

by Victoria Bailey

Elevance Health has announced plans to acquire Blue Cross and Blue Shield of Louisiana (BCBSLA), with the payers aiming to improve care access, quality, and affordability for Louisiana...

Blue Cross MN Value-Based Contract Reduced Cancer Care Costs

by Victoria Bailey

Blue Cross and Blue Shield of Minnesota (Blue Cross) has announced that its value-based contract with Minnesota Oncology reduced the total cost of care for patients during the first two years of the...

93% of Employees Satisfied with Employer Sponsored Health Insurance

by Victoria Bailey

The majority of Americans are satisfied with their employer-sponsored health insurance and cited it as the most important benefit an employer can offer, according to a poll conducted by Seven Letter...

BMA Shares How CMS Can Improve Medicare Advantage Program

by Victoria Bailey

Better Medicare Alliance (BMA) has called on CMS to improve the Medicare Advantage program by auditing all health plans annually, creating best practices for in-home health risk assessments, and...

Top 10 Highest Performing Medicare, Medicaid Health Plans

by Editorial Staff

The top-performing Medicare and Medicaid health plans for the 2020-21 plan year earned exceptional quality scores based on the plans’ customer satisfaction, preventive care, and treatment...

Problems with Medicare Advantage Payment System Contribute to Overpayment

by Kelsey Waddill

The Medicare Advantage program has serious structural problems that lead to overpayment and policymakers must take action on MedPAC’s recommendations in order to create a more cost-effective...

How Do Medicare Advantage Plans Compare to Traditional Medicare?

by Victoria Bailey

Medicare Advantage and traditional Medicare beneficiaries reported similar satisfaction rates, but access to care, affordability, and healthcare utilization differed among the two populations,...

NCQA Shares Health Plan Performance Ratings Ahead of Open Enrollment

by Victoria Bailey

The National Committee for Quality Assurance (NCQA) has released its 2022 Health Plan Ratings, revealing that most plans earned three stars or higher for overall health plan performance. Each year,...

Large Employers Aim to Redirect Healthcare Spending, Boost Quality

by Victoria Bailey

Purchaser Business Group on Health (PBGH) has announced a series of goals to help large employers redirect healthcare spending and improve care quality for its members over the next five...

Concerns about Cost of Healthcare Supersede COVID-19 Concerns in MA

by Kelsey Waddill

The cost of healthcare is more concerning than the risks of the coronavirus pandemic for Massachusetts residents, according to a poll commissioned by Blue Cross Blue Shield of Massachusetts (Blue...

Medicare Advantage Plan Quality Varies by Premium Cost

by Victoria Bailey

Premium costs may not always be representative of Medicare Advantage plan quality, as high-quality plans were found at every premium level, a study published in JAMA Health Forum found. Healthcare...