Fierce Healthcare

AUGUST 13, 2024

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 327

Medicare 327

Fierce Healthcare

APRIL 30, 2024

CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.

Medicare 333

Medicare 333

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 13, 2024

The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal

Medicare 321

Medicare Medicaid 321

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 351

Medicare 351

Fierce Healthcare

SEPTEMBER 20, 2024

Cigna is reshaping its Medicare Advantage (MA) plan lineup across eight states, affecting members in 36 health plans. Cigna is the latest company to rethink its Medicare Advantage offerings, choosing to cut plans in eight states including Florida.

Medicare 310

Medicare 310

Fierce Healthcare

JUNE 17, 2024

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.

Medicare 338

Medicare 338

Fierce Healthcare

OCTOBER 10, 2024

Just 40% of Medicare Advantage prescription drug plans offered in 2025 achieved a score of four stars or higher, the Centers for Medicare & Medicaid Services (CMS) revealed Oct. It's harder than ever for Medicare Advantage plans to score well on star ratings. Here's how they performed for 2025.

Medicare 315

Medicare Medicaid 315

Fierce Healthcare

JUNE 26, 2024

Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.

Medicare 315

Medicare 315

Fierce Healthcare

JULY 31, 2024

Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage (MA) space. Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage space.

Medicare 342

Medicare 342

Fierce Healthcare

AUGUST 27, 2024

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)

Medicare 330

Medicare 330

Fierce Healthcare

MARCH 15, 2024

Medicare households are spending far more on healthcare than other households, according to a new KFF analysis. Medicare households are spending far more on healthcare than other households, according to a new KFF analysis.

Medicare 318

Medicare Healthcare 318

Fierce Healthcare

DECEMBER 17, 2024

The Centers for Medicare & Medicaid Services (CMS) is discontinuing the Medicare Advantage (MA) Value-Based Insurance Design model at the end of 2025. | The Value-Based Insurance Design model for Medicare Advantage plans will be terminated at the end of next year.

Medicare 315

Medicare Medicaid 315

Fierce Healthcare

AUGUST 14, 2024

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)

Medicare 342

Medicare 342

Fierce Healthcare

SEPTEMBER 27, 2024

Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)

Medicare 301

Medicare Medicaid 301

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 315

Medicare Hospitals 315

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 336

Medicare Medicaid 336

Fierce Healthcare

OCTOBER 29, 2024

Accountable care organizations saved Medicare $2.1 billion, the largest yearly savings in program history, in 2023, the Centers for Medicare & Medicaid Services revealed on Tuesday. Accountable care organizations (ACOs) saved Medicare $2.1

Medicare 327

Medicare Accountable Care Accountability Medicaid 327

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 296

Medicare 296

Fierce Healthcare

JULY 11, 2024

A recent lawsuit has pushed back against an industry-opposed Centers for Medicare & Medicaid Services (CMS) final rule on broker compensation in Medicare Advantage (MA) plans. | A district court in Texas is halting a federal rule that changes broker compensation and overhauls marketing to seniors.

Medicare 310

Medicare Medicaid 310

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 309

Medicare 309

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 336

Medicare Hospitals 336

Fierce Healthcare

JUNE 9, 2023

Emerging Alzheimer’s disease medications come with high price tags, but researchers with the University of Chicago calculate that in the long run, it’s much less costly to cover these therapies for | Emerging Alzheimer’s medications come with high price tags, but researchers with the University of Chicago calculate that in the long run, it’s much less (..)

Medicare 363

Medicare 363

Fierce Healthcare

NOVEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | cut to physician payments in 2025 despite protest from major industry groups.

Medicare 330

Medicare Doctors Medicaid 330

Fierce Healthcare

MAY 13, 2024

The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation | A new report from RAND Corporation highlighted just how much more employers and private insurers are paying hospitals for inpatient and outpatient services. (..)

Medicare 336

Medicare Hospitals 336

Fierce Healthcare

MAY 9, 2024

Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding | Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments (..)

Medicare 307

Medicare Regulations 307

Fierce Healthcare

SEPTEMBER 6, 2024

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

Medicare 330

Medicare Doctors Medicaid 330

Fierce Healthcare

NOVEMBER 4, 2024

R-Louisiana, and Maggie Hassan, D-New Hampshire, published a policy paper advocating to impose site-neutral Medicare payments on hospitals. | The lawmakers argue that site-neutral Medicare payment reform would lead to lower healthcare costs for patients and save taxpayer dollars. Senators Bill Cassidy, M.D.,

Medicare 304

Medicare Hospitals Healthcare 304

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 324

Medicare 324

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 310

Medicare 310

Fierce Healthcare

OCTOBER 15, 2024

CareNu is starting to sign members up for health insurance through its Medicare Advantage plan for the first time. CareNu's subsidiary is launching an Institutional Special Needs Medicare Advantage plan in Florida for patients with chronic illness.

Medicare 308

Medicare 308

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 304

Medicare Healthcare 304

Health Care Dive

NOVEMBER 4, 2024

Physicians will see their Medicare reimbursement fall 2.9% next year if Congress doesn’t stop the cuts. Meanwhile, reimbursement for hospital outpatient departments is rising 2.9%.

Medicare 292

Medicare Hospitals 292

Health Care Dive

MARCH 22, 2024

Two weeks after the FDA updated Wegovy’s label, Medicare changed its stance to allow people with a history of heart disease to receive treatment, a shift that could further boost access to the fast-selling medicine.

Medicare 307

Medicare 307

Fierce Healthcare

OCTOBER 16, 2024

Medicare's annual enrollment period is officially underway, and, to assist beneficiaries in selecting plans, U.S. Medicare's annual enrollment period is officially underway, and to assist beneficiaries in selecting plans, U.S. News & World Report has released its list of the best Medicare Advantage and Part D insurers.

Medicare 284

Medicare 284

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 327

Medicare Medicaid 327

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 310

Medicare 310