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Medicare Advantage

Latest Headlines

Latest Headlines

Republican lawmakers blast Medicare Advantage cuts

Republicans claim the Obama administration is "masking" Medicare Advatage cuts now to avoid making voters angry in an election year, according to The Hill.

Why Medicare Advantage should function like exchanges

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.

New standards could expand provider networks

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.

Medicare, Part D plans must scrutinize pharmacy benefit manager practices, relationships

Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.

CMS wants more authority to recover Medicare Advantage overpayments

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.

Big data tools help CMS transform healthcare

New developments in data architecture, storage and analysis are helping the Centers for Medicare & Medicaid Services make better use of data to transform the healthcare system, according to a new  Health Affairs article.

Medicare Advantage: Trends, challenges and solutions

What's in store for insurers offering Medicare Advantage plans? They can expect more competition and less reimbursement. With more competition comes the need for insurers to keep operating costs low while maintaining compliance with regulations, said Robert Tracy (pictured), senior business director of government products at Independent Health.

MedPAC offers tips to improve Medicare payments

While the Medicare program continues to change and evolve, the Medicare Payment Advisory Commission (MedPAC) recommends the following considerations in its annual report to enhance Medicare payment systems.

Lessons in Medicare Advantage innovation

Attendees at the AHIP Institute in Seattle got a "fast and furious crash course" on innovating Medicare Advantage benefit design. They learned that insurers have to be creative with meeting the needs of MA beneficiaries to drive member engagement.

Medicare Advantage house calls: Necessary care or cash machine?

In-home health assessments of Medicare Advantage customers generate billions of dollars in payments to insurers, but the value of these services is in dispute. Payers say visits improve elder care, while critics say house calls are a vehicle for abusive billing, according to the Center for Public Integrity.