Insurance is evolving and Minneapolis-based Bright Health is a testament to the confidence shift toward technology-centered insurers. The healthcare startup just closed its largest funding round yet, totaling $200 million, a series C pool of capital that raised more money than expected.
Bright Health may be new in an industry...National News
An internal study released Tuesday shows Humana’s shift from the traditional fee-for-service (FFS) model to value-based care is cutting costs and improving quality of care for seniors enrolled in its Medicare Advantage (MA) plans.
The study found medical costs were almost 16 percent lower for seniors enrolled in Humana MA plans...Arizona News
Anthem individual insurance plans bid goodbye to Affordable Care Act (ACA) markets across the nation to focus on the growth of its Medicare Advantage business, an experience more sweet than bitter; the insurance giant's third quarter profits were up 29 percent, year over year.
Enrollment in Anthem's insurance plans may have taken...Arizona News
Medicare Advantage has been dominating healthcare headlines, especially with the start of the annual enrollment period; it is no secret the Medicare alternative pulls monstrous profits, but their means are in question. A study conducted by the Health and Human Services' (HHS) Office of the Inspector General (OIG) found that MA...Arizona News
In May, a final rule from the Centers for Medicare & Medicaid Services (CMS) opened the doors for Medicare Advantage (MA) insurers to offer long-term care benefits to members. About 7.5 percent of MA plan enrollees in 2019 may have access to in-home support services or extra benefits, according to CMS officials.
In a speech...Arizona News
MA insurers are auditing patient's medical charts to find more diagnosis codes in effort to get larger reimbursements from the Medicare program. The business of insurance encourages the documentation of all possible diagnoses to generate billions in profits. Modern Healthcare cites an Anthem lawsuit as an example of the returns...
The 21st Century Cures Act requires changes to the risk adjustment model for aged and disabled beneficiaries enrolled in Medicare Advantage Part C plans beginning in calendar year 2019.
For 2019, the agency proposes adding mental health, substance use disorder and chronic kidney disease conditions to the risk adjustment model and...