Medicare Advantage
publication date
Payer
Trump's DOJ Accuses Medicare Advantage Insurers of Paying 'Kickbacks' for Primo Customers
DOJ alleges insurers labeled payments as 'marketing' or 'sponsorship' fees to get around rules that set caps on broker commissions.
CEO
UnitedHealth Group Facing Criminal Probe for Medicare Fraud
It's the latest concerning development in a tumultuous stretch for the healthcare giant.
CFO
Financial Leaders Gather at the CFO Exchange to Plot Their Future
CFOs are meeting in Florida this week at HealthLeaders? annual event to discuss the top challenges facing health systems.
Payer
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get to Leave, Too
In the past 15 months, CMS has quietly offered roughly three-month special enrollment periods allowing MA members in 13 states...
Revenue Cycle
Infographic: MA Enrollment in 3 Charts
Growth in Medicare Advantage enrollment has slowed and plans are performing more poorly in quality ratings than in other recent...
Revenue Cycle
What Does Slowed MA Growth Mean for Rev Cycle Leaders?
Medicare Advantage enrollment grew at 3.9% last year despite market conditions unfavorable to payers.
CEO
HL Shorts: Why Providers Need to Educate Patients on Medicare Advantage
Combating deceptive marketing by Medicare Advantage plans can benefit patients and providers, says one hospital CEO.
Payer
Medicare Advantage: Why Members and Plans Paid More
Cost shares have as much as doubled as plans get a payment rate hike.
Payer
Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
In addition to the reimbursement issue, rural hospitals' complaints include payment delays and denials.
CEO
Why Jefferson Health Went Out of Network with Cigna
The health system has taken the contract dispute public while the two sides continue negotiations.
CEO
HL Shorts - Medicare Advantage Reforms Providers Want to See Made
A combination of policies in place and willingness from payers to be accountable is needed, says one hospital CEO.
Revenue Cycle
What's in the Wind for Revenue Cycle Leaders in 2025? Three Trends to Watch.
A quarterly analysis of KPI data shows claim denial rates on the rise while patients struggle to pay their growing...