MA Organizations Can Expect Biden Administration to Revisit RADV Rule
Notably missing from the Trump administration’s late-term rulemaking blitz was a longstanding proposal regarding Risk Adjustment Data Validation (RADV) audits, but industry observers say it will likely be revisite...
MA Plans’ Stars Innovations Prioritize Member Experience
In the ever-evolving world of star ratings, Medicare Advantage plans are at a unique crossroads where they must balance a bevy of changes to the measures used to determine their overall rating with managing membersâ...
MA, Cost, PACE, Demo, and Prescription Drug Plan Contract Enrollment Report (January 2021)
Preliminary figures from the 2021 Medicare Annual Election Period (AEP) indicate that total enrollment in Medicare Advantage plans surpassed 26.6 million as of the Jan. 1, 2021, payment date, which reflects enrollme...
News Briefs
✦ Anthem, Inc. stands to acquire more than 267,000 Medicare Advantage members and over 305,000 Medicaid members in Puerto Rico through the planned purchase of MMM Healthcare, LLC from InnovaCare Health. The deal...
Rate Notice Cites COVID Costs, Leaves Some Issues Unresolved
With less than a week to spare before the Jan. 20 inauguration of President Joe Biden, CMS on Jan. 15 followed up on its promise for an early release of the 2022 Medicare Advantage and Part D Rate Announcement, indi...
Tenn. ‘Block Grant,’ Other Waiver Approvals May Be Moot
As part of its late-term rulemaking and waiver-approving blitz, the Trump administration on Jan. 8 cleared the way for Tennessee to become the first state to accept a fixed amount of federal funds in exchange for a ...
2021 Outlook: Duals Plans Double Down on SDOH, Telehealth Investments
Amid the changes brought about by the COVID-19 pandemic, Medicare Advantage Special Needs Plans (SNPs) and others serving low-income dually eligible members are looking at ways to promote the use of telehealth and o...
Latest SDOH Guidance Highlights Long Road to Health Equity
As the COVID-19 pandemic has shone a bright light on many of the barriers facing low-income Medicaid enrollees and communities of color when it comes to accessing health care, plans have sought more ways to address ...
News Briefs
✦ UnitedHealth Group’s fourth-quarter 2020 adjusted earnings per share (EPS) fell 35% from the prior year to $2.52, as “care patterns normalized, while COVID-19 costs rose, and further rebates were recognized...
Centene Boosts Behavioral Health Offerings With Magellan Buy
Following the recent acquisition of PANTHERx Rare, LLC and the first- quarter 2020 addition of WellCare Health Plans, Inc., Centene Corp. kicked off the new year with an agreement to purchase Magellan Health, Inc. f...