Payers
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CMS: MA Premiums To Remain the Same for Most Beneficiaries in 2024
The average monthly plan premium for Medicare Advantage is expected to increase only slightly in 2024 from 2023, CMS said. About 73% of beneficiaries will see no increase at all.
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Study: MA Beneficiaries Have Lower Utilization Than Traditional Medicare
A new study found that MA beneficiaries have more than 50% fewer inpatient stays and 22% fewer emergency department visits than traditional Medicare enrollees.
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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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How MIPS Value Pathways will Prove the Value of Rehab Therapy
As value-based care models take hold, the time is ripe for rehab therapists to position themselves as primary players in the movement toward delivering optimal quality and value in the broader healthcare ecosystem.
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Report: 7 Ways Medicare Advantage Is Being Marketed on TV
There are concerns that Medicare Advantage TV ads are misleading patients. A new KFF analysis of Medicare Advantage TV ads found that the ads often rely on celebrity endorsements and suggest that seniors are missing out on benefits that they’re entitled to.
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Is the ‘Age Wave’ An Opportunity or a Challenge?
Americans are getting older, and some healthcare leaders expect this to be a challenge for the healthcare industry. Others, however, think this is an opportunity for the industry to make improvements, such as engaging adults in their care before they turn 65.
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HealthPartners Exec: The 5 Rules To Scale Value-Based Care in the Commercial Market
The commercial market has struggled to adopt value-based care, but HealthPartners has had some success, according to Mark Hansberry, senior vice president and chief marketing officer of the company. During a conference, he shared five rules for scaling value-based care, including creating trust and providing real-time data.
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Breaking Through Gridlock in the Mental Health Care System
For the gridlock in mental healthcare to be resolved, 100% of mental healthcare providers must practice measurement-based care, utilizing validated rating scales to monitor and measure longitudinal outcomes for every patient. And payers then must offer reimbursement that appropriately rewards providers for delivering high-quality, effective care, and incentivize proactive mental health management.
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Payer’s Place: Dr. Anil Singh, Highmark Health
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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Is Medicaid Expansion Still a Political Wedge Issue?
When Medicaid expansion was first enacted, it was a hot topic debate between Democrats and Republicans. But more and more states are starting to expand Medicaid, including several conservative states.
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Payer’s Place: Don Antonucci
The CEO of Providence Health Plan visits the Payer’s Place and addresses the future of payment models.
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What CVS Stands to Gain by Setting Up Biosimilar Subsidiary Cordavis
Pharmaceutical industry observers say CVS Health’s creation of Cordavis, a new biosimilar drugs company, is part of a strategy to make its move into this market as profitable as possible.
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Solera Health Launches Weight Management Solution for Payers and Employers
Solera Health recently launched a program that aims to help patients who are interested in GLP-1s gain access to lifestyle change support. It also provides educational materials on GLP-1s.
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Report: MA Enrollment Has Quadrupled in Rural Communities Since 2010
In rural areas, the share of eligible beneficiaries enrolled in MA plans nearly quadrupled from 11% in 2010 to 40% in 2023, according to new research from KFF. This represents 400,000 rural MA beneficiaries in 2010 and 1.8 million in 2023.
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Alignment Health: What Are Seniors’ Top Barriers to Care?
A new survey from Alignment Health found that economic instability, food insecurity, lack of support and transportation access are the biggest social barriers for seniors.
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MA Beneficiaries With Cancer Spend Less on Healthcare Than Traditional Medicare Beneficiaries
Medicare Advantage beneficiaries with a cancer diagnosis spend $3,996 on out-of-pocket costs and premiums annually, versus $6,091 for traditional Medicare beneficiaries with cancer, a new report found.
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Payer’s Place: Don Antonucci, Providence Health Plan
The CEO of Providence Health Plan visits the Payer’s Place and addresses the future of payment models.
