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.
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.
Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.
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.
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.
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.
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.
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.
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.
Last week brought bad news for Medicare Advantage, the health insurance plan covering nearly 16 million Americans. The Center for Public Integrity reported on billions of dollars overpaid to program...