Paula Blankenship, Author at The Hertel Report

Paula Blankenship

Communications professional with two decades of award-winning work in journalism, corporate communications, promotional video, public relations and higher education. Always seeking opportunities to serve the public good.

Author's Posts

National News

CMS & Senate Vow to Crackdown on MA & MA SNP as New Tailored Plans Emerge Targeting Latinos, Asian Americans & LGBTQ+ Medicare Beneficiaries

Although UnitedHealthcare's national footprint is expanding in 2024, the nation's and Arizona's largest MA insurer said last week it was reducing some MA service areas and discontinuing certain plans including AARP Medicare Advantage,...

Arizona News

New Arizona Commercial Plan: Zuniga Health Targets Hispanic Employees

The plans are designed specifically for small- to medium-sized Hispanic-owned businesses to encourage Hispanic employees to take control of their health in the easiest way possible. All services are offered in English and Spanish. The Miami-based start-up already operates in Illinois, Florida, and Texas, and is planning to also expand...

Arizona News

EEOC Resolves Disability Discrimination Lawsuit Against HonorHealth

As part of the resolution, Scottsdale-based HonorHealth has agreed to pay $1.75 million to about 100 former employees with disabilities who had sought reasonable accommodations from the non-profit health system. The settlement resolves a 2020 lawsuit brought by the U.S. Equal Employment Opportunity Commission (EEOC) alleging...

Arizona News

Employer Health Coverage Costs Expected to Rise 6.5% Nationally in 2024 - Arizona Rate Increase Submissions for Small Group Top 13%

Almost all existing small-group insurers planning to offer 2024 ACA-compliant health plans off the federal Marketplace in Arizona have submitted rate increases ranging from a 2.75% bump for an HMO product from Banner|Aetna to a 13.8% cost jump for PPO small-group product from Cigna. According to reporting from the Wall Street Journal,...

News

Driver of MA Growth: Number of Beneficiaries Switching from FFS Medicare to MA Triples Between 2006 and 2022

Most MA growth was driven by switchers and younger and healthier Medicare beneficiaries had better odds of switching from Original Medicare to Medicare Advantage (MA), but lower odds of switching from MA to Original Medicare. Complicating matters: older and sicker beneficiaries were more likely to switch out of MA into Original Medicare....

Arizona News

CMS Awards $3.3M for Arizona Navigators - 2024 Marketplace Enrollment Starts November 1

Since 2013, navigators have helped Americans understand their health insurance options and facilitated their enrollment in health insurance coverage through the Federally-facilitated Marketplace. The statewide award will support Arizona navigators who serve an important role in connecting communities to health coverage, including...

Arizona News

Pennant Acquires Valor Hospice Care, A Southern Arizona Hospice & Palliative Care Provider

Valor, a provider of skilled hospice services in Tucson, Green Valley, and Sierra Vista is now part of the Pennant Group. Nearly 48,470 Medicare beneficiaries in Arizona elected the hospice benefit in 2021, according to the U.S. Centers for Medicare & Medicaid Services (CMS). In 2020, Medicare was the largest payer of hospices...

Arizona News

Arizona's Devoted Health MA Network Partners with Evernorth Care Group

The health insurer covers about 13,000 Medicare lives across five counties in Arizona and earned a four-star rating in 2023 for its Medicare Advantage (MA) plans in the greater Phoenix area where Evernorth Care Group, the medical practice division of Cigna HealthCare of Arizona, operates 20 healthcare centers. Devoted Health MA...

Arizona News

Tucson Senior Living Operator Agrees to Pay $4.25M Over Alleged Kickback Scheme

The United States alleged that the home health agency operator Bayada purchased two of Watermark’s properties in Arizona to induce referrals of Medicare beneficiaries. A former Bayada executive earned about $3.8M for blowing the whistle. Based in Tucson, Watermark manages 79 senior retirement homes but the scheme was designed around...

Data Resources

2023 ACO/VBN Data Edition

With nearly 50 organizations claiming ACO status in Arizona, the market for value-based payment arrangements is accelerating, Medicare is saving and ACO profits are growing within the Medicare Shared Savings Program (MSSP) and the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. In 2022...

Arizona News

Everyone's A Winner: All Arizona MSSP ACOs in 2022 Earn Shared Savings

For the first time ever, all ACOs operating in Arizona earned shared savings as participants in the Medicare Shared Savings Program (MSSP) in 2022. Nationally, the MSSP saved Medicare $1.8 billion in 2022 compared to spending targets for the year. This marks the sixth consecutive year the program has generated overall savings and...

Arizona News

NAH Loses Appeal, Rezoning of Land for New Flagstaff Hospital Will Go To Voters

The Arizona Court of Appeals ruled voters will decide the rezoning of land near I-17 and I-40 on which Northern Arizona Healthcare is planning to construct a new hospital to replace the current Flagstaff Medical Center. Northern Arizona Healthcare appealed an earlier court decision about the rezoning referendum arguing the...

Arizona News

Banner Health Partners With evolved MD to Place Mental Health Providers at Primary Care Clinics

Under the program with evolvedMD, mental health services for Banner Health patients will soon be as close as one of Banner Health's Medical Group sites in metro Phoenix. The partnership means evolvedMD will place a licensed behavioral therapist to work with a Banner Health patient's PCP to provide mental health expertise, psychiatric...

Arizona News

Medicaid Disenrollment of Children - CMS Puts All 50 States on Notice

After reports of millions of children improperly dropped from Medicaid since redeterminations began last spring, the federal agency warned states August 30, 2023 of future federal action if their Medicaid and CHIP renewal requirements are out of compliance. In a letter to all state Medicaid directors, the Centers for Medicare and...

Arizona News

AzHFMA Fall Conference in Historic Prescott - September 10-12

The event venue - the Sam Hill Warehouse - was built in 1903 and has rightfully earned a spot on the National Register of Historic Places. Hosts are kicking things off Sunday afternoon with a Prescott Scavenger Hunt History Tour and Networking Happy Hour -- with a day and a half of top-tier educational content beginning Monday...

National News

CMS Proposes Draft Guidance on Monthly Payment Option for Part D Prescription Costs

Set to begin in 2025, the option to pay out-of-pocket costs for Part D drugs in monthly payments over a year was ratified in the Inflation Reduction Act (IRA). CMS is releasing the guidance in two parts, this week the focus across 56 pages is on helping Medicare Part D plan sponsors and pharmacies prepare for the new program and...

Arizona News

Doctors Complain They Pay Money for Nothing - EFTs Aren't Free

Doctors and hospitals are protesting electronic fund transfers from insurers that are tied to processing fees as high as 5%. Arizona physicians are also speaking up. This week's ProPublica reporting takes readers behind the history of how CMS seemingly flipped its position on electronic transfer fees attached to insurer's claim...

Arizona News

UHC Begins Prior Authorization Reduction September 1 - Second Phase Starts November 1

Arizona's top MA insurer's two-phased approach is expected to eliminate the prior authorization requirement for many procedure codes, equaling nearly 20% of UnitedHealthcare’s overall prior authorization (PA) volume. Starting September 1, some vein procedures, durable medical equipment, breast reconstruction, radiology,...

Arizona Comings & Goings

Abrazo Health Welcomes New CEO of Phoenix and Cave Creek Hospitals

Ruben Castro will oversee the Abrazo Scottsdale Campus on East Bell Road in Phoenix and the health system's micro-hospital in Cave Creek. Before joining Abrazo, he was chief operating officer at Las Palmas Medical Center in El Paso, Texas. "The northeast Valley is full of opportunity and I’m really excited about joining Abrazo....

Arizona News

Inflation Reduction Act Funds $40M in Support of HCBS in Arizona

This week many are celebrating the first birthday of the Inflation Reduction Act (IRA) which extends Marketplace affordability, caps the cost of insulin at $35 per month for Medicare beneficiaries, and improves access to affordable prescription drugs for millions of Americans. In Arizona, the Arizona Health Care Cost Containment System...

Page 1 of 21012 3 ...