With normal communications from CMS suspended, no January 2025 enrollment totals are available. Instead, The Hertel Report compiled end-of-year (EOY) Arizona Medicare Advantage enrollment totals and market penetration, as well as the agency's December 2024 dump of monetary sanctions against Elevance, Centene, and Humana, including plans...
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....Top of The Day
Two studies published this week highlight the differences between Medicare Advantage and traditional Medicare in terms of enrollment growth and use of certain medications.
The first study, published in JAMA Health Forum, found that MA plan payment cuts under the Affordable Care Act (ACA) did not lead to any enrollment reductions....White Papers, E books, Reports and more
Last week, the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy released an overview of the state of Medicare Advantage enrollment and program spending. This is the first such report since the Medicare to Medicare Advantage enrollment ratio hit 50-50.
The...
Medicare Advantage now manages the care for 45% of all Medicare beneficiaries, which demonstrates a +3% point improvement in penetration over 2021 and 9% increase in total enrollment year-over-year. Due to these rapidly increasing enrollment numbers, the program is dynamic and under regulatory scrutiny as it responds to patient...
The Medicare Payment Advisory Commission (MedPAC), the panel that advises Congress on Medicare policy, released new findings last Friday that demonstrate a surge in popularity for the Medicare Advantage program but raises alarms about upcoding practices that have spiked Medicare spending.
Over 50% of Medicare beneficiaries are...
A recently released analysis estimates federal (MA) overpayments between 2010 and 2019 resulted from private plans' "inventing new ways to increase their enrollees' risk scores," just as sales of Medicare Advantage (MA) plans skyrocket and SCAN launches "Welcome Health" an independent primary care medical group that will deliver...
In response to the coronavirus, the Centers for Medicare and Medicaid Services (CMS) granted a special enrollment period (SEP) for Medicare beneficiaries through the end of June, giving Part D, Medicare Advantage and Medigap insurers an additional sales window. The SEP applies to those who were unable to enroll due to the pandemic....
