SNP Enrollment Cuts Mortality, Utilization Rates for ESRD Patients
Medicare beneficiaries with end-stage renal disease (ESRD), a costly and complex population that often has other comorbidities and sees multiple physicians, may be better served in ESRD Special Needs Plans, a type o...
News Briefs
✦ The overall average scores for Medicare Advantage and Part D organizations subjected to 2019 program audits dropped from 1.03 in 2018 to 0.77, according to the 2019 Part C and Part D Program Audit and Enforceme...
Tech-Focused MA Startups Chase Tailwinds in New Markets
In advance of the 2021 Medicare Annual Election Period (AEP) that starts on Oct. 15, venture-backed Medicare Advantage firms like Alignment Healthcare and Clover Health are unveiling their plans for expansion while ...
Plans, Providers Pursue Lasting Change to MA Telehealth Policy
Before a pandemic forced the rapid adoption of telehealth in the U.S., the Trump administration had already implemented or was taking steps to support the use of telehealth in the Medicare Advantage program. But one...
Proposed MCIT Rule Aims to Speed Senior Access to Breakthrough Devices
Carrying out another directive from President Trump’s Medicare-focused executive order issued last fall (RMA 10/17/19, p. 3), CMS on Aug. 31 released a proposed rule that aims to fast-track Medicare coverage of c...
MA, Cost, PACE, Demo and Prescription Drug Plan Contract Enrollment Report (August 2020)
Enrollment in Medicare Advantage plans reached 25.2 million enrollees as of the Aug. 1, 2020, payment date, according to new monthly summary data from CMS. The payment reflects enrollments accepted through July 10. ...
News Briefs
Anthem Blue Cross and Blue Shield and Centene Corp.’s Managed Health Services (MHS) secured new four-year contracts to serve the Indiana state Medicaid program, Hoosier Care Connect. The new pacts, which start in...
E-Brokers Are Poised for Success in Digital Medicare AEP
As Medicare Advantage organizations prepare to promote their 2021 offerings this fall with no new guidance from CMS on marketing during a pandemic, plans and their broker partners are proceeding as though the safest...
Heal’s Home-Based Care Model Aims to Reduce Senior ER Use
As visits to hospitals and outpatient clinics have become sources of anxiety for patients worried about exposure to the novel coronavirus, plans and providers alike have begun to make major investments in home care....
MCOs Posting 2Q Earnings Saw Satisfactory Gains in MA
While second-quarter 2020 earnings calls centered largely on uncertainty related to the COVID-19 pandemic, insurers with a large Medicare Advantage presence expressed satisfaction in membership growth so far this ye...