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2025 outlook: What's next for Medicare Advantage

Fierce Healthcare

Medicare Advantage has steadily grown over the past decade, and now encompasses more than half of all seniors eligible for Medicare. Medicare Advantage has steadily grown over the past decade, and now encompasses more than half of all seniors eligible for Medicare.

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Medicare Advantage plans received billions from Medicare for home visits. The feds are skeptical

Fierce Healthcare

Medicare Advantage (MA) insurers, namely industry titans UnitedHealth Group and Humana, could be using health risk assessments and chart reviews to inflate payments from Medicare through upcoding, | A federal watchdog is questioning whether UnitedHealthcare, Humana and other Medicare Advantage payers are either creating diagnoses out of thin air to (..)

Medicare 302
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Medicare Advantage rate cut remains as feds keep up pressure

Fierce Healthcare

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 357
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CMS sunsets Medicare Advantage value-based model, citing billions in costs

Fierce Healthcare

The Centers for Medicare & Medicaid Services (CMS) is discontinuing the Medicare Advantage (MA) Value-Based Insurance Design model at the end of 2025. | The Value-Based Insurance Design model for Medicare Advantage plans will be terminated at the end of next year.

Medicare 297
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CMS: Negotiated drug prices would have saved Medicare $6B last year

Fierce Healthcare

The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.

Medicare 328
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CMS seeks input on improving transparency in Medicare Advantage

Fierce Healthcare

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

Medicare 312
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Medicare Advantage marketing practices draw ire from senators

Fierce Healthcare

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 341