Medicare Advantage
publication date
Strategy
Shift to Medicare Advantage Ratchets Up Pressure on Hospitals
The move to private Medicare Advantage takes hospitals further away from fee-for-service medicine, putting pressure on these providers to improve...
Finance
Medicare Advantage Plans Could Cover Meal Deliveries Next Year
The CMS proposal for 2020 would give plans more flexibility to cover supplemental benefits for people with chronic illnesses, including...
Finance
Deputy HHS Secretary Hargan Talks Stark Law, Kickbacks
HHS is examining ways to modernize the Stark Law to provide patients with more care options without undermining the rule's...
ACOs Saving Medicare Money, but MedPAC Sees Need for Changes
The commission found that spending on ACO beneficiaries was about 1.2% below the benchmarks set in 2017, but they questioned...
CMS Unveils New Part D Payment Model, 'Transformative Updates' to Existing MA Model
The two voluntary initiatives will launch in 2020, and CMS Administrator Seema Verma called them 'prime examples' of modernized Medicare...
Finance
Tenet, Humana Renew Multiyear Contract
The early renewal of a four-year contract ensures that Humana's 21 million members will have in-network access to Tenet hospitals...
Finance
Outlook 'Stable' for Health Insurers in 2019 Despite ACA Uncertainty
A robust job market bolstering employer-sponsored plans, Baby Boomers transitioning to Medicare Advantage, and ACA exchanges attracting new payers are...
Finance
DOJ Takes Aim at Sutter Health, Claiming Inflated MA Risk Scores
The government's participation in the False Claims Act case demonstrates its commitment 'to hold healthcare providers responsible if they fail...
Finance
Value-Based Care Leads to Reductions in ER Visits and Admissions
Humana's fifth annual value-based care study found that patients seen by physicians in value-based agreements had a 7% drop in...
Finance
Positive MA Growth Leads Humana to Boost Year-End Guidance
Just as in Q2, Louisville-based Humana bolstered its year-end guidance thanks to strong performance in its Medicare Advantage pool.
Innovation
Telehealth to Gain Ground in 2020 Under Medicare Advantage Proposal
Enrollees would have access to telehealth benefits regardless of whether they live in rural or urban areas, unlike the current...
Innovation
Alternative Payment Model Adoption Increases
The Health Care Payment Learning & Action Network study shows that the percentage of healthcare payments tied to APMs have...