Medicare Advantage

Latest Headlines

Latest Headlines

Study: Most Medicare Advantage members come from Medicare

Medicare Advantage is an increasingly popular choice among eligible consumers--including those who are already enrolled in traditional Medicare. In fact, at least half of new Medicare Advantage enrollees switched from Medicare each year.

Insurers ready to push back against another round of MA cuts

Insurers are readying efforts to fight back against another round of Medicare Advantage cuts that are expected to come next month. But the campaign to keep Medicare Advantage payments stable may be harder than last year due to the post-midterm election political environment.

Medicare Advantage plans could lose members to feds

If Medicare Advantage plans drop significant amount of providers from their networks, their affected members can leave those plans and enroll instead in traditional Medicare.

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.