The health insurance payment system is broken and the Affordable Care Act, which was supposed to lower costs, is actually contributing to the problem, MVP Health Care CEO Denise Gonick, told the Albany Business Review.
There have been a lot of changes to Medicare Advantage plans of late--UnitedHealth dropped providers in Alabama, Humana lost a big provider contract and MVP Health Care is discontinuing two of its plans.
Medicare Advantage plans are widely popular among Medicare-eligible consumers, but not everyone is fond of them. Many providers actually dislike the Medicare Advantage program and, therefore, are reluctant to contract with Medicare Advantage insurers.
Some state officials want more regulatory authority over Medicare Advantage plans. Right now, state regulators can't impose sanctions on Medicare Advantage plans; only the Centers for Medicare & Medicaid Services has that power.
Medicare spending will slow down over the next decade--and although this bodes well for the federal budget it could also slow down Medicare reform, notes a post in the Morning Consult.
Republicans claim the Obama administration is "masking" Medicare Advatage cuts now to avoid making voters angry in an election year, according to The Hill.
If Medicare Advantage plans had to compete for members like plans sold on the health insurance exchanges, insurers could provide high value at lower costs, reported the New York Times.
As health insurers' provider networks get more narrow, many states are adopting standards to ease consumer concerns about limited selections of doctors and hospitals, reports The New York Times.
Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.
The Centers for Medicare & Medicaid Services wants to establish a formal process that allows it to use a payment offset system to handle disputes with Medicare Advantage insurers about potential payment errors.