Fierce Healthcare

OCTOBER 17, 2023

Alignment Healthcare is teaming up with pharmacy giant Walgreens to launch new Medicare Advantage (MA) plans for 2024. Alignment Healthcare is teaming up with pharmacy giant Walgreens to launch new Medicare Advantage plans for 2024.

Medicare 190

Medicare Healthcare 190

Fierce Healthcare

MARCH 4, 2024

Medicare Advantage (MA) growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according to a new report from healthcare consultant C | Medicare Advantage growth has broadly slowed, but the biggest players in this space continue to claim the lion's share of this expansion, according (..)

Medicare 301

Medicare Healthcare 301

Fierce Healthcare

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 358

Medicare Medicaid 358

Fierce Healthcare

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 347

Medicare Healthcare 347

Fierce Healthcare

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 307

Medicare Hospitals 307

Fierce Healthcare

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 293

Medicare 293

Fierce Healthcare

APRIL 5, 2024

Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year | Medicare Advantage plans will need to adjust to new star ratings requirements, industry watchers warned following a final rule on Thursday.

Medicare 335

Medicare Medicaid 335

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 326

Medicare Medicaid Integration 326

Fierce Healthcare

JANUARY 12, 2024

A MedPAC meeting on the status of Medicare Advantage held Friday began with numbers on enrollment and insights into coding diagnoses, before devolving into contentious debate over the quality of th | Spirited disagreement arose during MedPAC's Medicare Advantage sessions on Friday, as members debated the merits of the program.

Medicare 307

Medicare 307

Fierce Healthcare

JANUARY 31, 2024

Medicare Advantage (MA) payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment. Medicare Advantage payments are set to decrease yet again in 2025 as the feds phase in significant changes to risk adjustment.

Medicare 307

Medicare 307

Fierce Healthcare

MARCH 5, 2024

A new-look Medicare Advantage (MA) quality bonus program would better incentivize insurers and help individuals choose a more appropriate plan, a report from Urban Institute finds. | A new report looks at how the Medicare Advantage quality bonus program could be improved, including taking the star ratings reporting private.

Medicare 242

Medicare 242

Fierce Healthcare

OCTOBER 9, 2023

LAS VEGAS—Medicare Advantage (MA) has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder. | LAS VEGAS—Medicare Advantage has only grown over the last decade, and, in tandem, voices criticizing the program have gotten louder.

Medicare 350

Medicare 350

Fierce Healthcare

NOVEMBER 6, 2023

Cigna is looking into the possibility of selling its Medicare Advantage (MA) business, according to a report from Reuters. Cigna may decide to sell off its Medicare Advantage business. The insurer is reportedly in early discussions with an investment bank to go over its options.

Medicare 293

Medicare 293

Fierce Healthcare

JANUARY 31, 2024

Cigna will sell off its Medicare business to Health Care Service Corporation in a deal valued at $3.7 HCSC will acquire Cigna's Medicare Advantage, Part D, supplemental benefits and CareAllies businesses, and the parties expect the deal to close in the first quarter of 2025. billion, the company announced Wednesday.

Medicare 307

Medicare 307

Fierce Healthcare

APRIL 3, 2024

To address the nation’s drug shortages, the Department of Health and Human Services (HHS) is floating a plan that would attach new Medicare payments and penalties to hospitals’ supply chain practic | A white paper penned by HHS outlines a potential program that would push hospitals toward inventory and purchasing practices that reinforce long-term (..)

Medicare 291

Medicare Hospitals 291

Fierce Healthcare

JANUARY 29, 2024

Medicare Advantage (MA) continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service. Medicare Advantage continues to grow, but there are signs that its profitability is on the decline, according to a new report from Moody's Investors Service.

Medicare 284

Medicare 284

Fierce Healthcare

FEBRUARY 9, 2024

A bipartisan group of senators announced Friday that they are working on new legislation for “long-term reforms” to physician payments under Medicare and other program changes. | The lawmakers plan to investigate and pass "long-term reforms" that will "ensure financial stability for providers," among other goals.

Medicare 322

Medicare 322

Fierce Healthcare

MARCH 15, 2024

Providers objected to its proposal to give physician reimbursement relief, while plans disagreed with its attitude toward Medicare Advantage. Health plans and providers alike are disgruntled with a new report (PDF) to Congress released | It seems everyone was left unsatisfied by MedPAC's newest report to Congress.

Medicare 334

Medicare 334

Fierce Healthcare

NOVEMBER 20, 2023

Traditional Medicare paid out an estimated $31.2 The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 326

Medicare Medicaid 326

Fierce Healthcare

DECEMBER 18, 2023

Payers need to properly adapt to changes made to the Medicare Advantage star ratings program or risk financial repercussions, industry experts told Fierce Healthcare. Payers are being urged to prioritize health equity considerations more than ever before to improve their Medicare Advantage star ratings scores.

Medicare 293

Medicare Healthcare 293

Fierce Healthcare

SEPTEMBER 19, 2023

The Centers for Medicare & Medicaid Services (CMS) finalized a rule Monday to streamline enrollment in Medicare Savings Programs (MSPs) with the aim of making coverage affordable for 860,000 mo | A $26.16 billion CMS rule will streamline Medicare Savings Program enrollment, reducing administrative burden in the process.

Medicare 293

Medicare Medicaid 293

Fierce Healthcare

SEPTEMBER 18, 2023

Seniors are becoming increasingly overburdened by marketing efforts from private Medicare plans, and low-income beneficiaries are twice as likely to file complaints regarding fraudulent phone calls | Fraudulent marketing practices are affecting low-income seniors looking for Medicare plans more than higher-income seniors, a new study has found.

Medicare 307

Medicare 307

Fierce Healthcare

OCTOBER 16, 2023

A research brief out of think tank Urban Institute evaluates the prospect of reducing Medicare spending by reining in excessive post-acute care rates. | New research shows that MedPAC's previous proposal for a unified payment structure for post-acute care could save Medicare billions.

Medicare 313

Medicare 313

Fierce Healthcare

SEPTEMBER 20, 2023

Traditional Medicare not only doesn’t measure up to Medicare Advantage (MA) when it comes to cutting back on utilization, it also falls short in many ways compared to commercial insurance for those | Researchers say Medicare Advantage enrollees have more than 50% fewer inpatient hospital stays than FFS Medicare enrollees and 22% fewer visits to emergency (..)

Medicare 335

Medicare Hospitals 335

Fierce Healthcare

FEBRUARY 6, 2024

Healthcare mergers and acquisitions are in no short supply as providers, health tech companies, retailers and other industry players look to expand their businesses and gain a competitive edge. Missouri's $10 billion health system merger, Cardinal Health's $1.2

Medicare 261

Medicare Healthcare 261

Fierce Healthcare

FEBRUARY 15, 2024

Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. ACOs could face lasting financial difficulties because of a recent, alleged $2 billion Medicare catheter fraud scheme.

Medicare 317

Medicare 317

Fierce Healthcare

SEPTEMBER 11, 2023

Members of MedPAC, the Medicare Payment Advisory Commission, reiterated their broad support for simplifying the Medicare Advantage (MA) landscape for consumers during a meeting Sept.

Medicare 284

Medicare 284

Fierce Healthcare

FEBRUARY 23, 2024

Just a few short months after making a push into the payer space, digital health company Waltz Health is stepping into the Medicare market. Just a few short months after making a push into the payer space, digital health company Waltz Health is stepping into the Medicare market.

Medicare 256

Medicare 256

Fierce Healthcare

NOVEMBER 21, 2023

A City of Hope analysis found that Medicare Advantage members faced a delay of two weeks or more between diagnosis and their first course of therapy.

Medicare 313

Medicare 313

Fierce Healthcare

DECEMBER 15, 2023

While its merger with Humana may have fallen through for now, Cigna is attracting plenty of interest for the rumored sale of its Medicare Advantage business, Bloomberg reported.

Medicare 299

Medicare 299

Fierce Healthcare

OCTOBER 27, 2023

The Department of Justice (DOJ) has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme. | The Department of Justice has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme.

Medicare 318

Medicare 318

Fierce Healthcare

OCTOBER 13, 2023

Approximately 42% of Medicare Advantage plans that offer prescription drug coverage will have a star rating of four or more in 2024, marking yet another substantial decrease from

Medicare 313

Medicare 313

Fierce Healthcare

SEPTEMBER 14, 2023

A third set of Medicare Part B prescription drugs will cost up to $618 less per average dose beginning Oct. 1, announced the Centers for Medicare & Medicaid Services (CMS). |

Medicare 322

Medicare Medicaid 322

Fierce Healthcare

NOVEMBER 15, 2023

UnitedHealthcare is facing a potential class action lawsuit following allegations that it used an algorithm to deny claims for post-acute care services in Medicare Advantage.

Medicare 355

Medicare 355

Fierce Healthcare

SEPTEMBER 26, 2023

Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.

Medicare 293

Medicare Medicaid 293

Fierce Healthcare

OCTOBER 4, 2023

Mental health provider Brightside Health is partnering with Centene, Optum, Lucet, Blue Cross and Blue Shield of Texas and other payers to serve 50 million people in Medicare and Medicaid. Brightside Health announced expanded partnerships with major health payers including Centene, Optum and Lucet on Thursday.

Medicaid 291

Medicaid Medicare 291

Fierce Healthcare

FEBRUARY 23, 2024

The agency said it is still litigating Medicare Advantage cases against major insurers. Under the False Claims Act, more than $1.8 billion last year, according to the Department of Justice.

Medicare 301

Medicare 301