Humana has revised its outlook, confident that its expected Medicare Advantage enrollment will increase even more than it originally anticipated in 2023. But Centene has reported the opposite, expecting to lose money in Medicare Advantage and from Medicaid redeterminations.
Centene released its first quarter (Q1) corporate reports on...
The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Advance Notice for the Medicare Advantage (MA) and Part D Prescription Drug Programs that would update next year's payment policies.
In addition to the payment updates, the advance notice outlines several updates and improvements made by...
Every year, ahead of the Medicare Advantage open enrollment period, the Centers for Medicare and Medicaid Services (CMS) publish Medicare Part C and Part D Star Ratings to give Medicare beneficiaries a metric by which to assess plans. Last week, CMS released the 2023 Star Ratings for qualifying MA plans.
Medicare Advantage plans are...
It's safe to say that Medicare Advantage is now a well-established industry all its own -- within but separate from both the Medicare program and commercial insurance. With this new market dominance, the Medicare Advantage industry is now facing the same things all major industries must deal with: increased oversight, regulation and...
Last week, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking comment on ways to improve Medicare Advantage and make the program more equitable, affordable and sustainable.
Medicare Advantage (MA) has been under great scrutiny lately, for policies on prior authorization, the adequacy...
The Centers for Medicare and Medicaid Services (CMS) released its star ratings for Medicare Advantage Part C and Part D star ratings last Thursday, ahead of Medicare open enrollment, which begins October 15. Medicare Advantage (MA) plans get a star rating from one to five each year based on performance metrics including patient...
This vendor produced case study provides insight on data-driven approaches that decreased costs , boosted HEDIS scores and CMS Star ratings for a prominent MA plan.
Carenet's approach provides a checklist to consider when choosing a strategy to boost member engagement and change member behavior:
Proactively...