Medicare Advantage
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MA Beneficiaries Have Fewer In-Network Options for Psychiatrists Than Other Insurance Types
A Health Affairs study discovered that nearly two-thirds of Medicare Advantage psychiatrist networks, or 64.6%, were narrow in 2019. Comparatively, about 43.1% of Medicaid managed care networks were narrow and 39.5% of ACA Marketplaces were narrow.
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MA Enrollees Less Likely To Be Prescribed High-risk Medications Than Traditional Medicare Enrollees
In 2018, there were 41.5 high-risk medications per 1,000 beneficiaries for Medicare Advantage, compared to 56.9 high-risk medications per 1,000 beneficiaries for traditional Medicare, a new study found.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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Mental Health Platform for Seniors Launches with $115M in Financing
Author Health helps seniors with serious mental illness and substance use disorders by working with Medicare Advantage plans. The company launched Wednesday with $115 million in financing, and announced that Humana is its first payer partner.
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Report: Medicare Spending Reached $744B in 2022
A new KFF analysis showed that Medicare spending per person increased to $15,700 in 2022 from $5,800 in 2000, representing a 4.6% average annual growth.
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Selling Its MA Business May Be Bright Health Group’s Only Option, Experts Say
Bright Health Group said last week it is “exploring strategic alternatives” for two Medicare Advantage plans in California: Brand New Day and Central Health Plan, which the insurtech purchased several years ago for $500 million. One expert said selling is necessary as the company faces bankruptcy.
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Report: MA Enrollment Increases to Half of All Eligible Medicare Beneficiaries
Out of 59.82 million people with Medicare Part A and Part B in January 2023, 30.19 million people were enrolled in Medicare Advantage plans, the Kaiser Family Foundation found in a recent analysis.
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Enrollment in MA Plans With $0 Premiums Is on the Decline, Report Finds
In 2023’s enrollment period, 84% of eHealth customers chose an MA plan with a $0 monthly premium, versus 87% in 2022, eHealth’s annual Medicare Index Report found. This is the first time popularity in $0 premium plans has decreased since eHealth started conducting the report in 2018, when 63% of customers selected a no-premium plan.
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In Which Areas of Healthcare Do Investors Want More Startup Activity?
While the digital health sector might feel a little cramped in some areas, there are wide open spaces in others — and investors are ready to funnel money into companies looking to innovate these lesser-discussed aspects of care delivery and healthcare technology. Some of these areas include Medicaid, generative AI and patient-to-patient support.
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Aledade, Humana Strike 10-Year VBC Collaboration
Aledade — an independent primary care network focused on value-based care — struck a 10-year partnership with insurer Humana. Under the collaboration, Humana’s Medicare Advantage members will receive primary care from Aledade physicians using value-based arrangements.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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Report: MA Gross Margins Were Double Other Health Insurance Markets’ in 2021
In 2021, Medicare Advantage gross margins averaged $1,730, more than double other insurance markets, the Kaiser Family Foundation report found. The individual market’s gross margins averaged $745 per enrollee, group market’s gross margins averaged $689 per enrollee and Medicaid managed care’s gross margins averaged $768 per enrollee.
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Report: Medicare Advantage Enrollment Sees Continued Growth, but at a Slower Rate
Enrollment in Medicare Advantage plans increased by 5.5% this year, or by 1.5 million beneficiaries, according to The Chartis Group. But in 2020, 2021 and 2022, enrollment rose by 1.9 million, 2.2 million and 2.3 million, respectively.
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MA Plans Rejected 2M Prior Authorization Requests in 2021
There were more than 35 million prior authorization requests submitted to MA plans in 2021, and 2 million were denied, according to KFF. Of those denied, just 11% were appealed. However, most of those appeals led to the denial being overturned.
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Report: Wisdo Reduces Loneliness Among Humana MA Members
Wisdo, a social health platform that addresses loneliness and social isolation, teamed up with Humana to serve some of its Medicare Advantage members. A new study on Humana’s members found that 58% of participants reported lower rates of loneliness after three months of using Wisdo’s app.
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Report: MA Performs Better Than Fee-for-service Medicare on Diabetes Care
Medicare Advantage patients with diabetes have higher prescription fill rates, fewer emergency department visits and lower total medical spending than traditional fee-for-service Medicare patients, a new report shows. They also received their diagnosis earlier.
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3 Steps CMS Can Take to Rein in Misleading MA Marketing
By creating a marketplace that empowers consumers to choose the right health care coverage for their unique and individual needs, CMS will continue to put consumers first and strengthen Medicare Advantage, already the chosen program of America’s seniors.
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Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
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Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
