Medicare Advantage
publication date
Payer
Are We Any Closer To VBID-X?
Yes and no, but keep an eye on CMS' growing Value-Based Insurance Design model.
Payer
Spotlight: Healthfirst's unique approach to Value-Based Insurance Design
The payer is one of only two Medicare Advantage plans focused solely on social drivers of health in its CMS...
Payer
Curbing the Marketing Problem in Medicare Advantage
Misleading marketing has run rampant in the private program for too long, though new CMS regulations will attempt to offer...
Payer
MA Star Ratings: A Path to Dominance or Billions in Losses?
The answer is both as payers benefit unevenly from CMS' fine turning.
Payer
Medicare Advantage in the Hot Seat: Challenges and Opportunities Part 1
The first look at a preview of HealthLeaders Payer Week, five days of in-depth coverage and exclusive interviews.
Payer
CVS Health Forecasting $1B Loss From Medicare Advantage's Star Ratings Drop
Only 21% of the payer's Medicare Advantage (MA) members are enrolled in plans with at least four stars.
Payer
Buprenorphine Battles Reveal Mixed Results
Pushback on DEA regulations is measured by medication coverage trends that are improving but still lag in many areas.
Payer
Medicare Advantage Riddled With Ghost Networks
Senate Finance Committee finds mental health provider directories are widely inaccurate in the private program.
Payer
Medicare Advantage Premiums Rising as Enrollees Opt for Lower Out-of-Pocket Costs
The popularity of zero-dollar premium plans in Medicare Advantage (MA) is on the decline.
Revenue Cycle
Prior Authorization Requirements in Medicare Advantage Have Gone Up, Not Down
Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care.
Payer
UnitedHealth Group 'Optimistic' About Continued Medicare Advantage Growth
The payer giant posted $91.9 billion in revenue for the first quarter of 2023, up 15% year-over-year.