Medicare Advantage

Latest Headlines

Latest Headlines

What caused the Medicare spending slowdown?

Back in 2009, the Congressional Budget Office predicted that Medicare spending would be $706 billion in 2014. But spending will end up amounting to $580 billion.    A number of factors contributed to this  $126 billion gap, according to a new analysis from the Kaiser Family Foundation.

Some Medicare Advantage plans better able to control risk factors

Medicare Advantage members of ethnic backgrounds with high blood pressure, heart disease or diabetes are much less likely than white members to have these risk factors under control, according to a new study published in the  New England Journal of Medicine. That poses a problem, as it can substantially raise individuals' risk of health complications and increase the need for otherwise unnecessary care.

Florida managed care company seized by state loses shot at redemption

Remember Florida Healthcare Plus, the managed care company that looked like it had a shot at redemption following an FBI raid and fraud arrests? Turns out that won't be the case.

Humana's ACO reduced costs by 19 percent

Humana's Medicare Advantage ACO has reduced costs by 19 percent.  The insurer analyzed data of nearly one million MA members from 2013 and found a number of measurable improvements.

A story of redemption and the value of self-reporting

Those who read about the  11 south Florida residents charged with defrauding Medicare for more than $25 million were probably just as horrified as the FBI to learn about the details of a case that used more than 1,200 expatriates to fraudulently collect Medicare reimbursement.

Part D plans adding specialty drug tier, coinsurance

All Medicare Advantage Part D prescription drug plans next year will be adding a new specialty tier, according to a new analysis from Avalere Health.

Medicare Advantage ratings hurt insurers with dual-eligible members

WellCare is calling out the Centers for Medicare & Medicaid Services for creating unfair Medicare Advantage ratings that put insurers with a high proportion of dual-eligible members at a disadvantage.

Old data hinders comparison of Medicare, Advantage plans

A study comparing Medicare Advantage plans and traditional Medicare on healthcare access and quality found substantial limitations--mainly that much of the available research was old, according to a report published by the Henry J. Kaiser Family Foundation.

OIG: New audits will focus on managed care, Medicare Advantage plans

While the government will continue pursuing allegations of fraud, waste and abuse by doctors, hospitals and suppliers in fiscal 2015, the Office of Inspector General's latest workplan turns an investigative eye on Medicare Advantage and plans sold pursuant to the Affordable Care Act, the Center for Public Integrity reported.

Insurers: Clean up your provider networks

I have a friend, let's call her Amy, who casually told me last week how she struggled to find a pediatrician for her children since moving to our town. She said all the doctors she had called either weren't accepting new patients or "don't take Affordable Care Act plans."