FierceHealthIT

SEPTEMBER 4, 2024

Humana reaffirmed its full-year guidance but is leaving 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond said during the Wells Fargo Healthcare Conference on Wedn | Humana is pulling back from Medicare Advantage markets and cutting benefits next year.

Medicare 127

Medicare 127

FierceHealthIT

OCTOBER 11, 2024

Analyses of 2025 Medicare Advantage star ratings continue to pour in and not all of it bodes well for the conventional juggernauts. UnitedHealth and Humana saw star ratings decrease, whereas insurtechs celebrated their scores. We break down how all major insurers—and their investors—are reacting.

Medicare 127

Medicare 127

FierceHealthIT

AUGUST 15, 2024

The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.

Medicare 135

Medicare 135

FierceHealthIT

AUGUST 13, 2024

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 131

Medicare 131

Mobi Health News

MAY 8, 2023

According to an audit by the Office of the Inspector General, Medicare improperly paid for $580 million of psychotherapy care, including $348 million of telehealth services, during the first year of the COVID-19 public health emergency.

Medicare 268

Medicare Telehealth Public Health 268

Health Populi

AUGUST 3, 2021

“You can trust us to help you find the right Medicare coverage for you and your lifestyle,” the tagline reads. It is, specifically, Midwest Heritage, Hy-Vee’s banking, insurance and investments subsidiary, that will implement the Medicare Aisle program.

Medicare 318

Medicare Primary Care Mental health Digital Health 318

FierceHealthIT

SEPTEMBER 30, 2024

As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period. | As the calendar turns to October, the health insurance industry is gearing up for Medicare's annual enrollment period.

Medicare 128

Medicare 128

FierceHealthIT

AUGUST 27, 2024

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)

Medicare 132

Medicare 132

FierceHealthIT

SEPTEMBER 27, 2024

Many counties do not have medication for opioid use disorder (MOUD) services available through providers and treatment programs, and even in counties that do, Medicare and Medicaid beneficiaries of | A new report from HHS OIG looked at access to medication for opioid use disorder services and found many high need counties do not have specialized providers. (..)

Medicare 129

Medicare 129

Mobi Health News

AUGUST 11, 2022

Researchers found remote patient monitoring use among Medicare beneficiaries increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.

Medicare 268

Medicare 268

FierceHealthIT

SEPTEMBER 6, 2024

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

Medicare 132

Medicare Telehealth 132

FierceHealthIT

AUGUST 14, 2024

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)

Medicare 137

Medicare 137

FierceHealthIT

JUNE 13, 2024

The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal

Medicare 129

Medicare 129

FierceHealthIT

JULY 31, 2024

Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage (MA) space. Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage space.

Medicare 137

Medicare 137

FierceHealthIT

SEPTEMBER 11, 2024

Enrollees in both traditional Medicare and Medicare Advantage have cost-sharing obligations for behavioral health services, a GAO report shows.

Medicare 122

Medicare 122

FierceHealthIT

JUNE 26, 2024

Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.

Medicare 127

Medicare 127

FierceHealthIT

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.

Medicare 143

Medicare 143

FierceHealthIT

JULY 11, 2024

A recent lawsuit has pushed back against an industry-opposed Centers for Medicare & Medicaid Services (CMS) final rule on broker compensation in Medicare Advantage (MA) plans. | A district court in Texas is halting a federal rule that changes broker compensation and overhauls marketing to seniors.

Medicare 125

Medicare 125

FierceHealthIT

JUNE 28, 2023

Medicare Advantage (MA) beneficiaries have fewer inpatient hospital stays and emergency department visits than beneficiaries in traditional fee-for-service Medicare, according to a

Medicare 125

Medicare 125

FierceHealthIT

APRIL 30, 2024

CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.

Medicare 133

Medicare 133

FierceHealthIT

JUNE 17, 2024

LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage (MA), and, amid rising criticism of the program, one industry leader is making the case that "nostalgia" for traditiona | LAS VEGAS—The eyes of many regulators and lawmakers are on Medicare Advantage, and amid rising criticism of the program, one industry leader (..)

Medicare 112

Medicare 112

FierceHealthIT

JUNE 17, 2024

Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.

Medicare 135

Medicare 135

FierceHealthIT

AUGUST 20, 2024

The upward trajectory of Medicare Advantage (MA) enrollment is likely to become an issue for hospitals and other healthcare providers forced to contend with plans’ prior authorization requirements | Prior authorization burdens and "a challenging contract negotiation season" on the horizon are likely headwinds for providers, and hospitals (..)

Medicare 131

Medicare 131

FierceHealthIT

SEPTEMBER 16, 2024

billion in Medicare Advantage quality bonus payments, according to a new analysis from KFF. Health plans are set to rake in $11.8

Medicare 132

Medicare 132

FierceHealthIT

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 131

Medicare 131

FierceHealthIT

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Medicare 127

Medicare 127

FierceHealthIT

MAY 13, 2024

Online therapy provider Talkspace is making a big push into the Medicare market, rolling out to approximately 13 million members in 11 states. Talkspace plans to expand to all 33 million traditional Medicare members, coupled with several Medicare Advantage plans, across all 50 states by the end of the year.

Medicare 119

Medicare Mental health 119

FierceHealthIT

OCTOBER 18, 2023

Seniors are forced to navigate a convoluted Medicare Advantage (MA) landscape for healthcare coverage, often only to be denied care, experts told legislators during a Senate Finance Committee heari | Senators and experts agreed Wednesday that marketing practices from Medicare Advantage plans are often overwhelming for seniors.

Medicare 138

Medicare 138

Healthcare IT News - Telehealth

JUNE 19, 2023

Over the last few years, Medicare Advantage plans have dramatically increased their deployment of telehealth systems for seniors. While some in the healthcare industry may be skeptical of telehealth’s utilization, particularly within the Medicare population, these plans continue to move full steam ahead.

Medicare 163

Medicare Telemedicine Primary Care Mental health 163

Mobi Health News

NOVEMBER 24, 2020

An Intro to Medicare - and how Digital Health companies can impact the nation’s biggest payer.

Medicare 309

Medicare Digital Health 309

FierceHealthIT

MAY 9, 2024

Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding | Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments (..)

Medicare 124

Medicare 124

FierceHealthIT

MARCH 15, 2024

Medicare households are spending far more on healthcare than other households, according to a new KFF analysis. Medicare households are spending far more on healthcare than other households, according to a new KFF analysis.

Medicare 128

Medicare 128

FierceHealthIT

FEBRUARY 28, 2024

Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week. Walgreens will now accept a slew of Medicare Advantage supplemental benefits online, including the option for home delivery, the company announced this week.

Medicare 120

Medicare 120

Healthcare IT News - Telehealth

FEBRUARY 22, 2024

Brightside Health will be entering into new and expanded payer partnerships to support telemental healthcare access through Medicare and Medicaid, teaming with companies such as Blue Shield of California, CareOregon and Centene.

Medicare 135

Medicare 135

FierceHealthIT

AUGUST 7, 2024

Centene is exiting six states through its WellCare Medicare Advantage subsidiary next year, investment bank Stephens has revealed. WellCare is leaving six states next year, impacting more than 37,000 Centene members across the country.

Medicare 122

Medicare 122

Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

Medicare 108

Medicare Medical Billing Healthcare IT Health IT 108

FierceHealthIT

JUNE 3, 2024

Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. Blue Cross and Blue Shield of Kansas City is opting out of the Medicare Advantage market.

Medicare 125

Medicare 125