One of the main provisions of the Inflation Reduction Act's Medicare reform package directly lowers out-of-pocket costs for beneficiaries by capping total individual spending at $2,000 per year. This is causing some issues in practice, which conservatives are seizing upon to criticize the program.
It also instructs insurers to cover...Top of The Day
Between new auditing policies from the U.S. Department of Health and Human Services, President Joe Biden's consumer protection initiatives curbing the use of third-party marketing organizations and Congressional reports on excessive spending, Medicare Advantage has had a pretty tough time. So the MA lobby, the Better Medicare Alliance...
On Monday, the Centers for Medicare and Medicaid Services (CMS) finalized the Rate Announcement for Medicare Advantage (MA) and Medicare Part D programs for Calendar Year (CY) 2025 which includes a rate increase of 3.7% in addition to finalized Part D rules.
The final rule didn't deviate much from the CMS proposed payment rate issued...
A new survey from the Commonwealth Fund, a thinktank that promotes improvements in the healthcare system, found that most older Americans say they like their coverage regardless of whether they are enrolled in Medicare Advantage or Medicare fee-for-service (FFS). However, more people in Medicare Advantage plans reported delays in care...
Last week, the Biden administration announced a proposed rule through the U.S. Department of Health and Human Services (HHS), Labor and the Treasury Department that would implement the independent dispute resolution process (IDR process) outlined by the No Surprises Act, which seeks to protect patients and medical services consumers from...
It was a big week for studies and reports on Medicare Advantage, both positive and negative for the industry as a whole.
The Better Medicare Alliance recruited ATI Advisory to conduct a study on how much Medicare Advantage beneficiaries save by comparison to beneficiaries with traditional Medicare. It found that MA enrollees save a...
It is now incredibly well established that Medicare Advantage is popular among seniors and gaining new members every year, so quickly in fact that it is expected to represent half of the Medicare market by 2026. The question on everyone's minds now is: What will Medicare Advantage do with all this success, and how can it improve to...National News
A new bill in the senate, proposed by Senator Debbie Stabenow (D-MI) and other Senate Democrats would allow people under 65 and over 50 to buy into Medicare. WEAU 13 reports that 27% of adults approaching retirement age are not confident that they can afford health insurance, and more than 25% have difficulties navigating insurance...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...National News
On Monday, June 24, President Trump directed a slew of federal agencies to start working on several transparency issues, including forcing hospitals and payers to reveal privately negotiated rates. Providers will also be expected to provide patients with an estimate of their out-of-pocket costs before a procedure.
Elected in part...National News
Accenture study shows 91% of patients want to know out-of-pocket costs, only 25% of providers can provide the estimates.
HealthLeaders Media reports providers shouldn’t be afraid of sharing cost estimate information—the majority of patients aren’t using it to shop around, but rather to better plan their budgets, and 60% of...
