Fierce Healthcare

JUNE 3, 2024

Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. Blue Cross and Blue Shield of Kansas City is opting out of the Medicare Advantage market.

Medicare 307

Medicare 307

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 312

Medicare Hospitals 312

Fierce Healthcare

MAY 9, 2024

Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding | Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments (..)

Medicare 304

Medicare Regulations 304

Fierce Healthcare

MAY 13, 2024

Online therapy provider Talkspace is making a big push into the Medicare market, rolling out to approximately 13 million members in 11 states. Talkspace plans to expand to all 33 million traditional Medicare members, coupled with several Medicare Advantage plans, across all 50 states by the end of the year.

Medicare 292

Medicare 292

Fierce Healthcare

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 307

Medicare Hospitals 307

Fierce Healthcare

MAY 13, 2024

The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation | A new report from RAND Corporation highlighted just how much more employers and private insurers are paying hospitals for inpatient and outpatient services. (..)

Medicare 335

Medicare Hospitals 335

Health Care Dive

MAY 20, 2024

On Friday, the committee released a white paper proposing Medicare adjust doctor reimbursement to account for inflation, a key goal for physician lobbies.

Medicare 264

Medicare Accountability Doctors 264

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 326

Medicare Medicaid Integration 326

Fierce Healthcare

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 293

Medicare 293

Fierce Healthcare

MARCH 15, 2024

Medicare households are spending far more on healthcare than other households, according to a new KFF analysis. Medicare households are spending far more on healthcare than other households, according to a new KFF analysis.

Medicare 316

Medicare Healthcare 316

Health Care Dive

MARCH 22, 2024

Two weeks after the FDA updated Wegovy’s label, Medicare changed its stance to allow people with a history of heart disease to receive treatment, a shift that could further boost access to the fast-selling medicine.

Medicare 331

Medicare 331

Fierce Healthcare

JUNE 4, 2024

SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services (CMS) inappropriately calculated its star ratings for the 2024 plan | SCAN Health Plan secured a court victory Monday when a federal judge agreed that the Centers for Medicare & Medicaid Services inappropriately calculated (..)

Medicare 293

Medicare Medicaid 293

Health Care Dive

FEBRUARY 2, 2024

The health insurer sees Medicare Advantage as an area for future growth, despite selling the division for $3.7 billion earlier this week. Cigna’s CEO called the sale a “win-win” on a call with investors Friday.

Medicare 290

Medicare 290

Fierce Healthcare

JANUARY 12, 2024

A MedPAC meeting on the status of Medicare Advantage held Friday began with numbers on enrollment and insights into coding diagnoses, before devolving into contentious debate over the quality of th | Spirited disagreement arose during MedPAC's Medicare Advantage sessions on Friday, as members debated the merits of the program.

Medicare 307

Medicare 307

Fierce Healthcare

APRIL 5, 2024

Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year | Medicare Advantage plans will need to adjust to new star ratings requirements, industry watchers warned following a final rule on Thursday.

Medicare 335

Medicare Medicaid 335

Fierce Healthcare

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 347

Medicare Healthcare 347

Health Care Dive

MAY 13, 2024

All major payers saw elevated utilization but only an unprepared few struggled with the trend, the Change Healthcare cyberattack caused minimal financial fallout and a new D-SNP rule opens the door to a Medicare growth opportunity.

Medicare 324

Medicare Healthcare 324

Fierce Healthcare

MARCH 4, 2024

Medicare Advantage (MA) growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according to a new report from healthcare consultant C | Medicare Advantage growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according (..)

Medicare 301

Medicare Healthcare 301

Fierce Healthcare

OCTOBER 9, 2023

LAS VEGAS—Medicare Advantage (MA) has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder. | LAS VEGAS—Medicare Advantage has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder.

Medicare 350

Medicare 350

Fierce Healthcare

JANUARY 31, 2024

Medicare Advantage (MA) payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment. Medicare Advantage payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment.

Medicare 307

Medicare 307

Fierce Healthcare

NOVEMBER 6, 2023

Cigna is looking into the possibility of selling its Medicare Advantage (MA) business, according to a report from Reuters. Cigna may decide to sell off its Medicare Advantage business. The insurer is reportedly in early discussions with an investment bank to go over its options.

Medicare 293

Medicare 293

Fierce Healthcare

MARCH 5, 2024

A new-look Medicare Advantage (MA) quality bonus program would better incentivize insurers and help individuals choose a more appropriate plan, a report from Urban Institute finds. | A new report looks at how the Medicare Advantage quality bonus program could be improved, including taking the star ratings reporting private.

Medicare 242

Medicare 242

Health Care Dive

MAY 7, 2024

The Medicare trustee’s new deadline for the trust fund’s insolvency is five years later than in last year’s report, but budget hawks warned action is still needed to shore up the insurance program’s finances.

Medicare 290

Medicare 290

Fierce Healthcare

JANUARY 31, 2024

Cigna will sell off its Medicare business to Health Care Service Corporation in a deal valued at $3.7 HCSC will acquire Cigna's Medicare Advantage, Part D, supplemental benefits and CareAllies businesses, and the parties expect the deal to close in the first quarter of 2025. billion, the company announced Wednesday.

Medicare 307

Medicare 307

Fierce Healthcare

NOVEMBER 20, 2023

Traditional Medicare paid out an estimated $31.2 The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 326

Medicare Medicaid 326

Health Care Dive

MARCH 5, 2024

Medicare Advantage beneficiaries were also less likely to improve self-care and mobility function, according to research published in JAMA Health Forum.

Medicare 313

Medicare 313

Fierce Healthcare

SEPTEMBER 19, 2023

The Centers for Medicare & Medicaid Services (CMS) finalized a rule Monday to streamline enrollment in Medicare Savings Programs (MSPs) with the aim of making coverage affordable for 860,000 mo | A $26.16 billion CMS rule will streamline Medicare Savings Program enrollment, reducing administrative burden in the process.

Medicare 293

Medicare Medicaid 293

Fierce Healthcare

SEPTEMBER 18, 2023

Seniors are becoming increasingly overburdened by marketing efforts from private Medicare plans, and low-income beneficiaries are twice as likely to file complaints regarding fraudulent phone calls | Fraudulent marketing practices are affecting low-income seniors looking for Medicare plans more than higher-income seniors, a new study has found.

Medicare 307

Medicare 307

Fierce Healthcare

JANUARY 29, 2024

Medicare Advantage (MA) continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service. Medicare Advantage continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service.

Medicare 284

Medicare 284

Fierce Healthcare

SEPTEMBER 20, 2023

Traditional Medicare not only doesn’t measure up to Medicare Advantage (MA) when it comes to cutting back on utilization, it also falls short in many ways compared to commercial insurance for those | Researchers say Medicare Advantage enrollees have more than 50% fewer inpatient hospital stays than FFS Medicare enrollees and 22% fewer visits to emergency (..)

Medicare 335

Medicare Hospitals 335

Fierce Healthcare

OCTOBER 16, 2023

A research brief out of think tank Urban Institute evaluates the prospect of reducing Medicare spending by reining in excessive post-acute care rates. | New research shows that MedPAC's previous proposal for a unified payment structure for post-acute care could save Medicare billions.

Medicare 313

Medicare 313

Fierce Healthcare

FEBRUARY 9, 2024

A bipartisan group of senators announced Friday that they are working on new legislation for “long-term reforms” to physician payments under Medicare and other program changes. | The lawmakers plan to investigate and pass "long-term reforms" that will "ensure financial stability for providers," among other goals.

Medicare 322

Medicare 322

Fierce Healthcare

SEPTEMBER 11, 2023

Members of MedPAC, the Medicare Payment Advisory Commission, reiterated their broad support for simplifying the Medicare Advantage (MA) landscape for consumers during a meeting Sept.

Medicare 284

Medicare 284

Fierce Healthcare

APRIL 3, 2024

To address the nation’s drug shortages, the Department of Health and Human Services (HHS) is floating a plan that would attach new Medicare payments and penalties to hospitals’ supply chain practic | A white paper penned by HHS outlines a potential program that would push hospitals toward inventory and purchasing practices that reinforce long-term (..)

Medicare 291

Medicare Hospitals 291

Fierce Healthcare

MARCH 15, 2024

Providers objected to its proposal to give physician reimbursement relief, while plans disagreed with its attitude toward Medicare Advantage. Health plans and providers alike are disgruntled with a new report (PDF) to Congress released | It seems everyone was left unsatisfied by MedPAC's newest report to Congress.

Medicare 334

Medicare 334

Fierce Healthcare

FEBRUARY 15, 2024

Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. ACOs could face lasting financial difficulties because of a recent, alleged $2 billion Medicare catheter fraud scheme.

Medicare 317

Medicare 317

Health Care Dive

SEPTEMBER 5, 2023

The payer, which brings in the bulk of its revenue from Medicare, is fighting back against a rule finalized earlier this year to claw back overpayments in the increasingly popular MA program.

Medicare 306

Medicare 306