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Medicare Advantage


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publication date

Payer
Nearly 9 in 10 Medicare Advantage Members Satisfied with Coverage
Jay Asser | June 16, 2022
Findings in a recent survey of beneficiaries push back on criticism of the service's administration.
Payer
Medicare Spending Fell in 2020 for the First Time in Over Two Decades
Jay Asser | June 10, 2022
The drop followed the decline in use of healthcare services during the early stages of the COVID-19 pandemic.
Payer
6 Markers of Growth, Loss, and Uncertainty from Moody's Q1 Insurer Report
Laura Beerman | June 02, 2022
EBITDA and Medicaid growth, commercial loses, higher medical loss ratios (MLR), and consolidation and subsidy doubts marked the quarter.
Revenue Cycle
Payers Failing to Follow Through on Prior Authorization Reforms
Jay Asser | June 02, 2022
A physician survey by the American Medical Association (AMA) reveals the administrative burden still falls on providers.
Revenue Cycle
Medicare Advantage Advocate Endorses Prior Authorization Bill
Jay Asser | May 27, 2022
The Improving Seniors' Timely Access to Care Act would set standards for prior authorization to cut down on unnecessary denials.
Payer
The Medicare Direct Contracting Controversy
Laura Beerman | May 26, 2022
Participants, supporters, and opponents weigh in on the role of Medicare Advantage subsidiaries as program design evolves.
Revenue Cycle
Department of Justice Asked to Investigate False Claims Act Violations
Jay Asser | May 20, 2022
The American Hospital Association (AHA) is asking for the creation of a task force to look into improper denials by...
Revenue Cycle
AHA Wants 'Swift Action' Against Restrictive Medicare Advantage Plans
Jay Asser | May 20, 2022
CMS is urged to take steps to increase MA plan oversight and address issues raised in an OIG report.
Payer
Clover Health's Andrew Toy: 'I Want to Double Down on Health Equity'
Laura Beerman | May 12, 2022
The Clover Health president links the company?s open-network model to greater equity for patients and providers.
Revenue Cycle
Medicare Advantage Prior Authorizations Are Often Unnecessarily Denied
Jay Asser | May 06, 2022
A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care.
Payer
Predicting How Plans Should Prepare After CMS Final Rate Announcement
Laura Beerman | April 11, 2022
CMS' final 2023 Rate Announcement included risk adjustment and health equity surprises.
Payer
Aetna Partnership Decreases Member Social Determinant: Loneliness
Laura Beerman | April 07, 2022
Medicare Advantage plans collaborate with companionship companies to meet non-medical needs and collect data that grows member trust and revenue.
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