Medicare Advantage

Latest Headlines

Latest Headlines

Tech-savvy startup Clover Health raises $160M

Startup health insurer Clover Health has raised $160 million in Series C funding from private investors.

3 tips to prepare Medicare's annual change and coverage documents

As the June 6 deadline for submitting materials for the Medicare annual election period closes in, one consultant shares tips for preparing the documents for popular Medicare Advantage plans.

HHS misses key opportunities for improper payment recovery

While it generally complied with federal improper payment reporting requirements, the Department of Health and Human Services fell short in several key areas, according to an independent audit conducted by Ernst & Young LLP.  

Medicare Advantage enrollment continues its steady growth

Medicare Advantage enrollment continued its steady climb in 2016, with 17.6 million beneficiaries accounting for nearly one-third of all Medicare beneficiaries, according to analysis released by the Kaiser Family Foundation.    

GAO calls for 'fundamental improvements' to Medicare Advantage auditing

The government's leading watchdog agency called on the Centers for Medicare and Medicaid Services to make "fundamental improvements" to its Medicare Advantage auditing process, which has been plagued with inefficiencies and recovered only a small percentage of estimated improper payments, according to a report released on Tuesday.  

Highmark will pay up to $5.5M for improved diagnostic documentation

Highmark has set aside up to $5.5 million to compensate Pennsylvania primary care physicians who improve how they identify, assess, document and report diagnosis codes for Medicare Advantage and Affordable Care Act health plan members.

Health economist: Competitive Medicare Advantage bidding could save gov't billions

Lack of a competitive bidding process in Medicare Advantage costs the government billions in overpayments. But plans to introduce it are probably doomed, according to a New York Times columnist....

How CMS proposes to align Medicaid managed care with private plans

Among the many provisions in the newly finalized rule for Medicaid managed care, the federal government seeks to align MMC regulations with ones that govern other privately managed plans.  

Teaching hospitals can prepare for value-based care with integrated network alliances

Healthcare's transition from fee-for-service to value-based care models is hitting teaching hospitals especially hard. However, if such hospitals strengthen their ties to integrated delivery networks that emphasize primary care and multispecialty group practice, they can significantly improve their chances of a successful transition, argues a post from the NEJM   Catalyst blog.

MACRA proposed rule: What it means for Medicare Advantage

Medicare's newly proposed physician payment overhaul includes clues that federal health officials want to credit participation in Medicare Advantage plans toward alternative payment models.