Medicare Advantage
publication date
Payer
Nearly 9 in 10 Medicare Advantage Members Satisfied with CoverageFindings 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 DecadesThe 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 ReportEBITDA 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 ReformsA physician survey by the American Medical Association (AMA) reveals the administrative burden still falls on providers.
Revenue Cycle
Medicare Advantage Advocate Endorses Prior Authorization BillThe Improving Seniors' Timely Access to Care Act would set standards for prior authorization to cut down on unnecessary denials.
Payer
The Medicare Direct Contracting ControversyParticipants, 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 ViolationsThe 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 PlansCMS 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'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 DeniedA 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 AnnouncementCMS' final 2023 Rate Announcement included risk adjustment and health equity surprises.
Payer
Aetna Partnership Decreases Member Social Determinant: LonelinessMedicare Advantage plans collaborate with companionship companies to meet non-medical needs and collect data that grows member trust and revenue.