23+ hour, 24+ min ago  (384+ words) New research from the Elevance Health Public Policy Institute finds that higher enrollment in Medicare Advantage may be linked to lower overall Medicare spending. Enrollment in Medicare Advantage has steadily increased over the past two decades. The number of MA…...

4+ day, 3+ hour ago  (300+ words) Chapter, a Medicare navigation platform, announced on Thursday that it raised $100 million in Series E funding. The New York-based company's AI platform compares health plans from every insurance carrier, including Humana, United Healthcare and Cigna. Seniors using the platform can…...

6+ day, 20+ hour ago  (657+ words) Healthcare leaders can't tell whether value-based care and Medicare Advantage are truly lowering costs. Some see promise in these models and ongoing innovations, while others say the programs haven't delivered measurable savings and point to direct contracting as a more…...

3+ week, 3+ day ago  (646+ words) Providence announced its intent to sell its health plan, exiting the "payvider" model as rising costs and operational complexity weigh on smaller regional insurers. The move reflects a broader trend of health systems refocusing on core care delivery and exploring…...

1+ mon, 1+ week ago  (464+ words) The $556 million settlement announced in January between the U. S. Department of Justice and Kaiser Permanente affiliates represents a turning point for Medicare Advantage oversight. That is because tools exist today for health systems " and government auditors " to identify unsupported diagnoses, validate…...

1+ mon, 2+ week ago  (209+ words) Further change in the Star Ratings program is inevitable, but one thing won't change: plans that make targeted investments in improving the member experience and clinical outcomes, driven by data, are the most likely to succeed and achieve a higher…...

5+ mon, 3+ day ago  (810+ words) Julius Bruch is the CEO and co-founder of Isaac Health, a scalable platform for brain health and dementia care that partners with leading healthcare organizations to provide expert screening, assessment, treatment, and care management for people living with dementia and…...

2+ mon, 3+ day ago  (768+ words) The challenge for policymakers is balance: encouraging rigor without unintentionally weakening a program that now serves the majority of Medicare beneficiaries. Thoughtful rate calibration can determine whether this transition strengthens the program or strains it unnecessarily. None of those changes…...

4+ mon, 1+ week ago  (431+ words) CMS is proposing major changes to Medicare Advantage Star Ratings, drawing mixed reactions from healthcare leaders. In recent years, there have been numerous lawsuits from Medicare Advantage plans against the Centers for Medicare and Medicaid Services over Star Ratings, including…...

2+ mon, 1+ week ago  (425+ words) Included Health is launching an alternative health plan centered on primary care, AI support, price transparency and easier navigation. Included Health, a navigation and virtual care company, is launching into the insurance space with its alternative plan design for employers,…...