With Record Unemployment, Recession Alters Medicare ‘Age-In’ Landscape
As shutdowns tied to the COVID-19 pandemic have led to the highest unemployment rate seen in the U.S. since the Great Depression, the current recession appears to be reversing the trend of Medicare “age-ins” put...
Is Molina the Next Aggregator of Smaller Medicaid Plans?
With an increasing share of seniors enrolling each year, a healthy rate environment and a meaningful return on scale, Medicare Advantage is largely seen as a safe space for insurers and one that is likely to drive m...
News Briefs
✦ The Pennsylvania Dept. of Human Services (DHS) on July 8 named the successful respondents to its latest request for applications to serve some 2.6 million HealthChoices enrollees, but the agency said it is unab...
ESRD Enrollment Creates Cost, Network Unknowns for MAOs
As Medicare Advantage plans prepare to enroll patients with end-stage renal disease (ESRD) this fall, a recent change to network adequacy measurement will give them some flexibility in how they include dialysis care...
Star Ratings Take Aim at Member Experience in ‘Huge’ Shift
CMS, building on its multi-year theme of emphasizing member experience within Medicare Advantage (MA), is increasing the weight of member experience measures beginning with the 2021 star ratings. By the 2023 star ra...
Post-COVID, Centene Foresees Expansion in MA and Medicaid
Providing updated guidance three months into the COVID-19 pandemic, managed Medicaid leader Centene Corp. last month raised its full year adjusted earnings per share outlook by 20 cents at the midpoint to an EPS ran...
Rule Raises Questions About Telehealth, Directory Accuracy
As Medicare Advantage and other insurers report increasing use of telehealth during the COVID-19 pandemic and consider the larger role that virtual visits could play on a more permanent basis, CMS recently finalized...
News Briefs
✦ Centene Corp. said June 30 that its Illinois subsidiary, Meridian Health Plan of Illinois, Inc., agreed to acquire the membership of Next Level Health Partners, Inc. The deal calls for Meridian to transfer it...
Pressure Mounts on MA Plans to Address Racial Disparities
As protests erupt across the U.S. calling for racial justice and police reforms, the COVID-19 pandemic continues to bring to light many of the racial disparities in health care, putting pressure on policymakers and ...
Provider Pact, Consumer Focus Aid Alignment’s Growth Story
Although major Medicare Advantage insurers grabbed the bulk of enrollees during the recent Medicare Open Enrollment Period, several smaller plans made significant headway in the OEP that reflected their Annual Elect...