As the open enrollment period (OEP) nears its close March 31, insurers participating in Arizona's Medicare Advantage market have picked up about 10,000 new members with county penetration rates ranging from a low of 16% in Apache County to 58% in Santa Cruz County.
The Centers for Medicare & Medicaid Services reported March 2021...
This week, COVID-19 continues to impact the data collection and maintenance of Medicare Advantage and Medicaid Managed Care programs. MedPAC reasserts its findings that Medicare Advantage costs the government more than fee-for-service and Oklahoma asks "is now really the time to be privatizing Medicaid?"
Medicare Advantage
The...Arizona News
This week in commercial health insurance news, a study suggests there could be new ways to innovate cost savings for employers, commercial payers are pushing surgery centers over hospitals, and how utilization during COVID-19 is affecting profits for insurance companies. Also, a Kaiser study demonstrates that tying insurance...National News
As the Medicare Advantage (MA) open enrollment period is underway, some studies are indicating the reasons for the popularity of the MA program and the ways in which enrollees navigate between plans. Additionally, studies show that the Medicare program is likely underpaying hospitals for care provided to beneficiaries.
Data from the...National News
Last week, the Better Medicare Alliance — a non-profit research and advocacy group that promotes Medicare Advantage plans — released a study conducted with Morning Consult demonstrating that beneficiaries are almost universally happy with their Medicare Advantage (MA) plans. Of more than 1,200 seniors on Medicare, 97% approved of...National News
As a year that upended healthcare comes to close, the Centers for Medicaid and Medicare Services (CMS) has published insights into how health spending in 2019 differed from the year prior, shedding light on trends that may factor into the industry’s pandemic recovery.
The report, published in HealthAffairs, showed that last...National Reports & Surveys
A new report comparing health outcomes for beneficiaries of Medicare Advantage (MA) and those on traditional fee-for-service Medicare found that MA beneficiaries spend far fewer days in skilled nursing facilities.
In Arizona, 2020 Medicare Advantage (MA) total enrollment was 574,475, with a 9% increase from 2019.
The report from...National News
In September, the Centers for Medicare and Medicaid Services released the Evaluation Report of the First Three Years (2017-2019) of the Medicare Advantage Value-Based Insurance Design Model Test, conducted by RAND Health Care.
The Value-Based Insurance Design (VBID) allows Medicare Advantage (MA) plans to offer incentives to...Arizona News
In 2018 and 2019, CMS paved the way for supplemental benefits in MA plans by granting more flexibility for insurers. They have taken advantage.
A recent analysis from Milliman found that the number of Medicare Advantage plans across the country that offered at least one supplemental benefit increased by 64% from 2020 to 2021....National News
Providers may use the authority of special needs plans within the MA program to focus on increasing enrollment for their specific types of patients and residents.
Long-term care (LTC) provider-led special needs plans (SNPs) increased from 76 plans in 2020 to 98 plans in 2021. According to ATI Advisory,which released the data on...National News
Value-based care models are increasing in popularity as companies demonstrate effective cost savings as a result of switching to such models. However, despite Medicare and Medicaid programs incentivizing towards more value-based care models, the greater risk taken on by these organizations has been shaken up by the COVID-19...Arizona News
In the early months of the pandemic, the federal Medicare program and private health insurance companies wanted to encourage people to use alternatives to in-person care by talking with a doctor over video or by telephone. There has been a 3,200% spike in telemedicine visits in Arizona, according to AHIP.
Now, some Americans will...Arizona News
Cigna is charged with falsifying the health conditions of its Medicare Advantage plan members, essentially scamming CMS out of larger payments to cover the cost of care for beneficiaries diagnosed through the insurer's medical assessment program.
Last year the Office of Inspector General undertook a study because it suspected...Arizona News
Walmart and Amazon are two of the latest corporations to break into private health insurance. Walmart Insurance Services LLC is a new plan by the company to sell plans to consumers and Amazon Care is directed specifically to deliver primary care services to employees and family members.
According to Business Insider, Walmart’s...CMS Rules
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....CMS Rules
The Centers for Medicare and Medicaid Services (CMS) finalized requirements seeking to increase access to telehealth for seniors in Medicare Advantage (MA) plans. The changes made to MA and Medicare Part D also expand supplemental benefit options for beneficiaries with chronic diseases.
CMS will grant MA plans more flexibility to...White Papers, E books, Reports and more
The analysis found the proportion of Medicare Advantage beneficiaries enrolled in a Special Needs Plan (SNP) more than doubled from 2012 to 2015, and an increasing number of enrollees had social risk factors.
The May Commonwealth Issue Brief recommends MA plans develop targeted interventions to address beneficiaries’ social...National News
Humana joined a slew of other companies in withdrawing guidance for 2020 amid coronavirus uncertainties but the healthcare giant decided to stick to its Medicare Advantage guidance for the year, despite pulling its Medicaid outlook.
The company beat Wall Street estimates, posting an 18% revenue increase to $19 billion compared to...National News
COVID-19 has rapidly changed the way healthcare looks in America, and Medicare Advantage is caught in the heart of the storm.
According to Kaiser Family Foundation, enrollment in MA plans more than doubled in the last decade, from 11.1 to 24.1 million. But now, the pandemic poses a particular threat to MA’s beneficiaries,...Arizona News
The state's lineup of Medicare Advantage insurers hasn't changed, but from January 1 to March 31, enrollees could switch to Original Medicare or switch to a new MA plan with an optional Part D Plan (PDP). The Hertel Report kept up with the changes.
Arizona's MA market gained about 12,000 members during OEP and the AARP branded...