FinanceThe Huge Opportunity to Use Technology to Bring 'Great Healthcare to More People': Interview With Clover Health's Andrew Toy
The visionary executive of a technology-oriented Medicare Advantage company outlines the future in this sector and the importance of being...
Revenue CycleNew Legislation Aims to Eliminate Some Prior Authorization Burdens
Establishing an electronic prior authorization process and requiring HHS to establish a process for "real-time decisions" for items and services...
Payer2022 Medicare Advantage Plan Overview, Part One: Costs and Leading Carriers
"Medicare consumers overall ... crave stability of benefits and a hassle-free experience that gets them the care and coverage they...
PayerPre-2022 Annual Enrollment, a Look Back at 2021 Medicare Advantage Plan Features
"As Medicare Advantage takes on an even larger presence in the Medicare program ? [it will] be important to monitor...
PayerSanford Health Plan Launches Bundled MA Product
The new plan -- Align powered by Sanford Health Plan ? covers Medicare Advantage enrollees in South Dakota, North Dakota...
PayerAnthem, UnitedHealthcare MA Plans Sanctioned for Missing MLR Threshold
When a Medicare Advantage plan fails for three straight years to meet the 85% threshold, CMS must suspend them from...
TelehealthAfter 3 Months of Declines Telehealth Use Stabilizes
Before May, telehealth as a percentage of medical claims had steadily fallen from February through April.
PayerOIG: Medicare Advantage Overpaid Anthem $3.5M
Anthem disputed the findings and rejected the recommendations in its rebuttal of the report.
TelehealthBusiness Leaders, Healthcare Stakeholders Urge Congress to Support Audio-only Telehealth
U.S. Chamber of Commerce, Harvard Pilgrim, Ascension, and others back audio-only Medicare Advantage bill.
StrategyHumana Health Plan Overcharged Medicare by Nearly $200M, Federal Audit Finds
The OIG's recommendation to repay, if finalized, would be "by far the largest" audit penalty ever imposed on a Medicare...
StrategyStudy Finds Ongoing Confusion Among Medicare Beneficiaries
GoHealth CMO, Paul Hain, MD, shares misconceptions Medicare beneficiaries have about Original Medicare and Medicare Advantage.
InnovationVirtual Care Key to Humana-Mercy Value-Based Contract
Medicare Advantage contract between Humana and Mercy expands to offer patients access to Mercy Virtual services. The arrangement is part...