Health Insurers Outline Medicare Expansion Plans
Humana projects that it will add 330,000 to 340,000 new Medicare Advantage members this year. It has targeted these growth opportunities:
- Medicare age-ins as baby boomers retire
- Group Medicare business
- Longer-term Medicare/Medicaid dual-eligibles
It has formed an alliance with CareSource, a Dayton, Ohio-based Medicaid health plan, to serve dual-eligibles in several states. CareSource operates primarily in Ohio and Michigan, but through this alliance is expected to expand its geographic footprint.
The utilization trend that began in 2011 continues with the first quarter showing a "modest" increase across Medicare, Medicaid, and its commercial lines of business. Outpatient and inpatient each posted increased utilization with inpatient "very restrained." Hospital bed days were flat to down in each business line.
The pending acquisition of two South Florida health plans will help boost Medicaid and Medicare Advantage membership. Miami-based Preferred Care Partners and Coral Gables-based Medica HealthCare Plans will add about 12,000 Medicaid members and 85,000 Medicare Advantage members. The acquisition also includes eight primary care centers.
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services
- Telehealth Improves Patient Care in ICUs
- Hospital M&A Volume Up, Value Down in 3Q
- 50 Years of Fighting Pressure Ulcers Called Into Question
- Douglas Hawthorne—A Chance to Do Something Big
- States Rejecting Medicaid Expansion Forgo Billions in Federal Funds
- Why You Should Involve Patients in Nursing Handoffs
- Nonprofit Hospital Outlook 'Negative' in 2014
- The 5 Biggest Healthcare Finance Trouble Spots