Earlier this month, the Commonwealth Fund published its State Scorecard for Medicare Performance, which evaluates each state's infrastructure, access to hospitals, beneficiary access to non-medical supports, regional variety in plan availability, out-of-pocket costs and other critical access of Medicare delivery.
The State Scorecard...
The Centers for Medicare & Medicaid Services (CMS) made changes this week impacting Medicare Advantage (MA) plans as they prep for AEP — while brokers were also bracing for another hit to their commissions from the program’s dominant insurer, UnitedHealthcare.
The agency decided MA members don’t need reminders about unused...
More insurers are planning to jump the Medicare Advantage ship, or at least scale back program participation in 2025.
It's anticipated that next year will bring fewer MA plans and supplemental benefit offerings following increased oversight by the Biden administration on overpayments to MA companies, which will lead to a projected...
The Biden administration brought down the hammer on Medicare Advantage insurers and their brokers when the Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Advantage Part D final rule last Thursday.
The rule increases regulatory scrutiny on prior authorization, network adequacy standards and marketing for...
The data in this recently published chartbook illustrates where and how many MA plans are offering certain nonmedical supplemental benefits and which MA organizations offer the most plans with a given benefit in 2024.
The report doesn't assess the effectiveness or use of supplemental benefits, but provides useful information to...
On Monday, the Centers for Medicare and Medicaid Services (CMS) proposed a new rule that would impose tighter regulations on Medicare Advantage insurers. The rule covers some hotly debated issues including prior authorization, supplemental benefits and marketing.
President Joe Biden announced last year that his administration would...
A new audit conducted by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that between 2015 and 2016, insurer Aetna received $25.5 million in Medicare Advantage overpayments. Also, plans are developing new offerings that aim to target the needs of specific demographics.
The OIG audit...
Medicare Advantage (MA) plans in collaboration with the Centers for Medicare and Medicaid Services (CMS) offers comprehensive healthcare services covered by Traditional Medicare (TM) with many now providing robust supplemental benefits. MA continues to grow rapidly and covers half of all eligible Medicare members from diverse...
The Medicare Payment Advisory Commission (MedPAC) published its annual June Report to Congress, which includes suggestions to unify payment methodologies for post-acute care, address issues within Medicare Advantage, and lower telehealth payments.
The MedPAC recommendations for streamlining payment methodologies for skilled nursing...
Lawmakers and stakeholders are still very upset with the U.S. Department of Health and Human Services' (HHS) plan to cut payments to the Medicare Advantage (MA) program and to enforce regulations against MA plans that have benefitted financially from improper overpayments. This week, HHS Secretary Xavier Becerra defended the rule in two...
Last week, the Centers for Medicare and Medicaid Services (CMS) announced plans to extend the Medicare Advantage (MA) Value-Based Insurance Design Model for five more years, through 2030.
According to the American Hospital Association, 52 Medicare Advantage organizations with a collective 9.3 million enrollees are participating int he...
Health insurance lobbyists and plans have put a ton of work into defending the Medicare Advantage (MA) program from proposed cuts and rule changes by the Centers for Medicare and Medicaid Services (CMS), but this week traditional Medicare gets community support of its own. And one insurer breaks from the pack to support the rule...
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...
If one thing is certain for 2023, it's that Medicare Advantage (MA) enrollment will continue to rise. As a tighter economy impacts retirement packages and seniors' ability to cover medical costs, supplemental benefits packages offered by MA plans will lead the charge in this wave of enrollment.
As early as February 2022, nearly 20% of...
Medicare-eligible seniors face more options than ever when considering Medicare Advantage (MA) and supplemental coverage. This year, the average beneficiary has nearly 70 different MA and Medicare Part D stand-alone plan options, with a litany of supplemental benefit offerings including many related directly to primary care.
According...
Medicare Advantage plans are a staple in the Medicare market, and as they grow to eclipse the total number of beneficiaries represented by Traditional Medicare, the position MA plans play will need to become more refined. This week, a number of MA plans announced moves into new markets.
The critical distinction between MA and Medicare...
Last Friday, the House of Representatives passed the Build Back Better Act, the massive social and climate spending bill that carries the promises of the Biden presidential platform. After several months of negotiations between democrats and revisions in the plan for how the bill would get passed, the bill is considerably smaller and...
The Medicare enrollment period has surpassed the halfway point for the 2022 calendar year (CY) and trends are already apparent. Supplemental benefits and in-home services are demonstrating huge gains for Medicare Advantage (MA) plans that offer them, although the $0 premium remains the most consistent choice for enrollees.
Online...
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....
