RADAR on Medicare Advantage

CMS Proposes 1% Rate Increase for MA Plans in 2021 and New Program Flexibilities

CMS on Feb. 5 released Part II of the Advance Notice proposing payment changes for Medicare Advantage and Part D plans for 2021, but at press time did not include the draft Call Letter. The agency also posted a prop...

MAOs Mull ‘Memory Fitness’ in Crowded Supp Benefit Market

Surveys have shown that cognitive decline is a chief concern among aging adults, yet brain health and “memory fitness” remain largely untapped areas as Medicare Advantage insurers experiment with new benefit des...

Post-AEP Surveying Could Inform 2021 MA Benefit Design

With supplemental benefits increasingly playing a role in shopping and switching behavior, Medicare Advantage carriers should be doing everything they can to highlight their supplemental offerings for existing and n...

News Briefs

✦ Humana Inc. on Feb. 4 said it partnered with private equity firm Welsh, Carson, Anderson & Stowe (WCAS) to expand access to value-based care for Medicare patients. Through the new joint venture, the partne...

Kansas Medicaid Deal Has Implications for Expansion Holdouts

In a move that may turn heads in other historically red states that have held off on expanding Medicaid under the Affordable Care Act (ACA), Kansas Gov. Laura Kelly (D) and Republican Senate Majority Leader Jim Denn...

2021 Advance Notice Elevates EDS Use, Leaves Out ESRD

The biggest news out of CMS’s Jan. 6 release of Part I of the 2021 Advance Notice may be that there was no news. As expected, CMS proposed continuing to phase out risk score data based on diagnoses contained in th...

CMS Suggests Use of NPPES for Verifying MA Directory Entries

Though a small assist in the gargantuan task that is improving Medicare Advantage provider directory accuracy, CMS’s new plan to use the National Plan and Provider Enumeration System (NPPES) as a reference source ...

Early Look at AEP Data Shows Medicare Advantage Membership Gains of 8.8%

Preliminary enrollment figures from the 2020 Annual Election Period (AEP) indicate that Medicare Advantage enrollment surpassed 24.3 million lives, up 8.8% from 22.4 million posted a year ago. The January enrollment...

News Briefs

✦ Bright Health plans to acquire California-based family-owned health plan Universal Care. Doing business as Brand New Day, the 37-year-old company serves Medicare-eligible seniors and special needs populations...

2020 Outlook: MA ‘Winners’ Must Focus on Differentiation, Integration

With early signs of strong enrollment growth in 2020 and a healthy pay outlook in 2021 given the elimination of the Affordable Care Act health insurer fee and an anticipated rate increase, the sun continues to shine...