RADAR on Medicare Advantage

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...

2020 Outlook: SNPs Look to States, CMS for Direction on Duals Integration

For Medicare Advantage Special Needs Plans (SNPs) and other insurers serving individuals who are eligible for both Medicare and Medicaid, 2020 “will be the year of building momentum for integration of dual eligibl...

CMS Releases Long-Awaited RFA on MA Hospice Model

Medicare Advantage organizations interested in testing the inclusion of a hospice benefit through their plans in 2021 will be tasked with ensuring timely and appropriate access to high-quality hospice care while als...