Study: More Medicare Patients Dying At Home

The Medicare Advantage program continues to grow in popularity with both consumers and health plans.

At least one-third of seniors are estimated to be in an MA plan rather than fee-for-service Medicare. As baby boomers retire in large numbers, health plans are competing to capture the Medicare Advantage market.

Medicare Drug Prices Up Despite Decrease in Prescriptions

The Medicare Advantage program continues to grow in popularity with both consumers and health plans.

At least one-third of seniors are estimated to be in an MA plan rather than fee-for-service Medicare. As baby boomers retire in large numbers, health plans are competing to capture the Medicare Advantage market.

Medicare Advantage Plans Grow With Star Ratings

The Medicare Advantage program continues to grow in popularity with both consumers and health plans.

At least one-third of seniors are estimated to be in an MA plan rather than fee-for-service Medicare. As baby boomers retire in large numbers, health plans are competing to capture the Medicare Advantage market.

Slash Payments for Emergency Departments: MedPAC Suggests

Prior Authorization AI

MedPAC proposed to slash payments in its March report to Congress. The commission specifically recommended a 30 percent payment rate reduction for off-campus standalone EDs that are no more than six miles from an on-campus hospital ED, according to the AHA.

Innovations in Medicaid Managed Care Organizations

Survey Results Define CMO Responsibilities

The first nationwide benchmark study measuring the health care industry’s progress in combating the opioid crisis was released. This important baseline analysis shows the positive steps clinicians and insurance plans have taken together – and identifies specific actions that can be taken to reduce addiction and abuse.

Kentucky Medicaid Lawsuit Guide: 5 Things To Know

Medicaid fraud

On January 24, 2018, 15 Kentucky Medicaid enrollees filed a lawsuit in the U.S. District Court for the District of Columbia challenging CMS’s authority to issue the work requirement policy and approve the Kentucky waiver. This issue brief answers 5 key questions about the Kentucky Medicaid Lawsuit.

Medicaid Expansion Linked To Better Clinical Care

Medicaid Expansion

ACA Medicaid expansion, was associated with an increased probability of patients presenting with less complicated surgical disease and a greater likelihood of patients receiving optimal surgical management after admission and linked to better access to surgery and higher quality surgical care, according to a new study from Harvard T.H. Chan School of Public Health.

Health Plan Effects On States And Nation

Healthcare Data Management

America’s Health Insurance Plans (AHIP) released a report which details health plan effects by state, including the District of Columbia.
“More people than ever have health care coverage today. But, for plans, their commitments are about so much more.” says Dr. Richard Bankowitz, Chief Medical Officer for AHIP.