Pharmacy-related quality outcomes were better in states where Medicaid managed care organizations administered health plans’ pharmacy benefits, according to a report from Elevance Health.
The...
Adults with cardiovascular disease are more likely to utilize outpatient cardiovascular services in Medicaid expansion states than in nonexpansion states, a study published in Health Affairs...
Medicare Advantage beneficiaries were less likely to have avoidable hospitalizations than those in traditional Medicare, suggesting that the use of provider networks in Medicare Advantage may reduce...
Although US veterans have many coverage options, including Veterans Affairs (VA), Medicaid, and the Affordable Care Act (ACA) marketplace, many are projected to remain uninsured in 2024, according to a...
CMS has proposed provisions to improve protections for Medicare Advantage beneficiaries, prevent anti-competitive practices, and strengthen access to behavioral healthcare services.
The Contract Year...
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...
Medicaid programs are leveraging community health workers (CHWs) to improve patient navigation, quality of care, and cultural competency, a Manatt Health newsletter found.
“The use of CHWs...
Going into the 2024 open enrollment season, healthcare stakeholders should be prepared for nine key trends in Affordable Care Act marketplace enrollment, according to experts from KFF.
First,...
The Department of Health and Human Services (HHS) will ensure access to a coronavirus therapy from Pfizer for Medicare and Medicaid beneficiaries and the uninsured through a patient assistance program,...
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...
Monthly Medicare Part B premiums will increase by nearly $10 in 2024 due to a projected increase in healthcare spending, CMS announced.
Medicare Part B covers physician services, outpatient hospital...
The Medicare drug price negotiation provisions in the Inflation Reduction Act hold promising spending reductions for beneficiaries, but drug companies are not backing down without a fight.
In August...
Medicaid managed care enrollment was not associated with poorer specialty care access for children with special healthcare needs, but it was tied to greater caregiver frustration and reduced mental...
In historically redlined areas, states that adopted Medicaid expansion saw lower uninsurance rates than nonexpansion states, a study published in Health Affairs uncovered.
Redlined areas were...
CMS is reminding state health officials of the upcoming continuous coverage requirements for children in Medicaid and the Children’s Health Insurance Program (CHIP).
Provisions in the...
While Congress has taken steps to ensure continuous eligibility for children on Medicaid, data indicates that expanding continuous eligibility to adults could result in lower uninsurance, some cost...
Ahead of the Medicare Open Enrollment Period, CMS has announced that Medicare Advantage premiums, benefits, and plan choices will remain relatively stable in 2024.
“A top priority for CMS...
Almost half a million children and families will regain Medicaid or Children’s Health Insurance Plan (CHIP) coverage after CMS identified system errors in states that led to improper...
The Affordable Care Act (ACA) marketplace was designed to incentivize enrollees to choose specific plans based on price and it seems to be fulfilling that goal, an analysis from the Urban Institute...
Medicare Advantage beneficiaries with cancer experienced lower out-of-pocket costs and had access to more benefits than those in Medicare fee-for-service (FFS), research conducted by ATI Advisory and...
