Medicare Advantage

Latest Headlines

Latest Headlines

More provider-sponsored health plans in the Medicare Advantage market

Nearly 60 percent of new entrants to the Medicare Advantage market are provider-sponsored health plans, according to a new report from Avalere Health.  

CMS sanctions Cigna over 'substantial failures' in Medicare plans

Federal regulators have banned Cigna from selling new Medicare products because of issues with its Part C and Part D plans that increased enrollees' out-of-pocket expenses which led to delays or denials in receiving medical services and prescription drugs.  

Report: CMS underpays Medicare Advantage plans for treating chronic conditions

The Centers for Medicare & Medicaid Services underpaid Medicare Advantage health plans for the costs of treating individuals with multiple chronic conditions, according to a new analysis from Avalere Health.  

Humana predicts 2016 losses in individual market

Humana is expected to record financial and membership losses tied to its Affordable Care Act plans, according to a new filing with the U.S. Securities and Exchange Commission, though the insurance giant does expect gains in Medicare Advantage.  

The case for integrating Medicare Advantage, ACOs

Though Medicare Advantage plans are not included in the federal government's goal to transition Medicare to a value-based payment system, they should be, according to a recent  Health Affairs  blog post.

CMS held back on audits, leading to billions in Medicare Advantage overpayments

The Centers for Medicare & Medicaid Services knew as far back as 2008 that certain Medicare Advantage plans were pocketing billions in overpayments, but officials still held back on auditing the plans and recouping payments tied to inflated risk scores, according to government records obtained by the Center for Public Integrity.  

Humana-ACO partnership improves health measures

In their first year of working together, a Pennsylvania accountable care organization and Humana have been able to improve health measures among Medicare Advantage members.  

Medicare Advantage could see sizable payment shifts

The government's proposed changes to its risk-adjustment model for Medicare Advantage plans could result in large payment increases and decreases depending on where seniors live, according to an analysis by Avalere Health.

UnitedHealth's HouseCalls reduces hospital readmissions

HouseCalls, a program that sends a physician or a nurse practitioner to on a home visit to Medicare Advantage members, cut both hospital and nursing home admissions, according to a new study. 

What's changing with Medicare Advantage plans in 2016

Medicare Advantage plan choices are changing in 2016, and these changes include plan availability, premium costs, drug price deductibles and satisfaction ratings, according to a new report from the Kaiser Family Foundation.