Healthpayer Intelligence Medicare Advantage
Listing Websites about Healthpayer Intelligence Medicare Advantage
Medicare Advantage Final Rule Addresses Prior Authorization, …
(4 days ago) WEBApril 05, 2023 - CMS has finalized a Medicare Advantage rule that aims to increase marketing oversight, streamline prior authorization requirements, and improve access to affordable prescription
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HealthPayerIntelligence News - HealthPayerIntelligence
(Just Now) WEBHumana reports Medicare Advantage growth, income gains in Q1 2024. April 25, 2024 by Victoria Bailey. Humana added 50,000 individual Medicare Advantage beneficiaries and reported a net income of
https://healthpayerintelligence.com/news
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Health Payer Intelligence: Medicare Advantage Evaluation Requires
(1 days ago) WEBBy Thomas Beaton February 23, 2018 - The growth of the Medicare Advantage (MA) market requires the release of more claims data to evaluate the commercial and government impact of the program, according to a recent JAMA commentary from the Health Care Cost Institute, ProPublica, and the VA. Despite the important and increasing …
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CMS issues AI guidance for Medicare Advantage plans
(Just Now) WEBAlgorithms and artificial intelligence-powered software tools can be used to support Medicare Advantage plans in making coverage decisions for members, but payers are still bound by CMS' internal benefits requirements and nondiscrimination rules under the ACA, the agency said in guidance to insurers regarding its final 2024 MA rule. "We are …
https://www.beckerspayer.com/policy-updates/cms-issues-ai-guidance-for-medicare-advantage-plans.html
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Medicare Advantage plan member satisfaction increases in 2022: …
(7 days ago) WEBTwitter. Medicare Advantage member satisfaction increased in 2022, with Kaiser Foundation Health Plan ranked the highest overall, according to J.D. Power, reports Healthpayer Intelligence. Overall
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HealthPayerIntelligence LinkedIn
(7 days ago) WEBhealth insurance, health payer, value-based care, Healthcare Insurance News, and Value-Based Contracting Around 42 percent of Medicare Advantage plans received 2024 star ratings of four or
https://www.linkedin.com/showcase/healthpayerintelligence
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HealthPayerIntelligence on LinkedIn: CMS Proposes 3.7% Increase …
(5 days ago) WEBWith new Medicare Advantage marketing regulations in place for 2024, payers must work with their marketing teams and establish proactive oversight programs to ensure compliance. https://bit.ly/3rnJTTG
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Medicare Advantage 2022 Spotlight: First Look KFF
(6 days ago) WEBFor 2022, the average Medicare beneficiary has access to 39 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by nine firms.
https://www.kff.org/medicare/issue-brief/medicare-advantage-2022-spotlight-first-look/
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HealthPayerIntelligence: At-Home Testing Coverage for Medicare
(8 days ago) WEBWhen CMS announced that it would require commercial health plans to cover over-the-counter coronavirus tests, the announcement raised a common outcry among payers, who pointed to the lack of at-home tests that were available due to supply chain issues. The second hurdle that will continue to have an impact despite Medicare …
https://achp.org/clip-healthpayerintelligence-at-home-testing-coverage-for-medicare-beneficiaries/
Category: Coronavirus Show Health
What’s new with Medicare Advantage - naviHealth
(4 days ago) WEBMedicare Advantage participation continues to increase. Released this July, the report states more than one in three Medicare beneficiaries are currently enrolled in Medicare Advantage. This high rate of participation correlates with a 49% jump in the number of plans available since 2017, according to Health Payer Intelligence. Also, …
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HealthPayerIntelligence on LinkedIn: Medicare Advantage Star …
(9 days ago) WEBAround 42 percent of Medicare Advantage plans received 2024 star ratings of four or higher, down from 51 percent in 2023. https://bit.ly/3M4VM8i
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Medicare Advantage two-midnight rule contributing to higher …
(9 days ago) WEBAn analysis of Medicare Advantage encounters from 2023 – before the rule was expanded to those patients – found that 22.3% were held in observation status for two days or more. By comparison, 8.7% of Medicare patients and 11.3% of patients covered by commercial plans had observation lengths of stay of two days or more in 2023.
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Medicare Advantage unrest, Change Healthcare fallout and more …
(4 days ago) WEBHumana’s net income fell to $741 million in the quarter from $1.2 billion in the same time last year because of surging medical expenses. The insurer, the second largest MA payer after
Category: Medical Show Health
Health care quality metrics higher in Medicare Advantage plans: …
(6 days ago) WEBMedicare Advantage PPO clinical quality performance was also better than traditional Medicare, but the differences were narrower. reports Healthpayer Intelligence. Researchers used data from
https://www.businessinsurance.com/article/20230405/STORY/912356614
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UnitedHealth wants Medicare Advantage algorithm denials suit …
(7 days ago) WEBUnitedHealth Group said a proposed class-action lawsuit alleging an AI algorithm wrongfully denied Medicare Advantage patients care should be dismissed because "plaintiffs have failed to exhaust the exclusive administrative appeal process set by the Medicare Act for challenging coverage determinations." "The Medicare Act, CMS …
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Unlocking Better Health: The Role of Personal Health Literacy in
(6 days ago) WEBSince 2010, Medicare Advantage enrollment has quadrupled in rural areas, where residents often face significant challenges in accessing healthcare services due to fewer providers and longer travel
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Blog: The impact of delayed and deferred care - naviHealth
(1 days ago) WEBFewer than 1.5 million total Medicare Advantage (MA) claims were filed in April 2020, a 66% drop from nearly 4 million in April 2019, according to a report in Healthpayer Intelligence News, which warned of the possibility of “a sicker population and lower payments” in 2021. Less than half of the beneficiaries who filed a claim in April …
https://navihealth.com/essentialinsights/the-impact-of-delayed-and-deferred-care/
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What to expect in the NSA’s independent dispute resolution process
(Just Now) WEBHealth plans that fall under the NSA provisions include plans in the group health insurance marketplace, Federal Employees Health Benefits (FEHB) Program carriers, and health insurance issuers.
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Radiology provider joins growing number of institutions refusing …
(7 days ago) WEB“Medicare Advantage undermines my expertise as a physician and disregards my patients’ unique medical needs. I believe traditional Medicare is the best option.” CMS released the 2025 Medicare Advantage rate announcement on April 1, projecting payments next year of between $500 billion and $600 billion.
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Blue Cross Blue Shield in the headlines: 10 updates
(Just Now) WEBBCBS Association and Blue Health Intelligence released a study in May that found a majority of patients taking weight loss drugs discontinue use of their medication before reaching a clinically meaningful health benefit. 3. Medicare Advantage extras on the chopping block in 2025 ; Big payers ranked by 2023 profit; Adventist, Blue Shield of
https://www.beckerspayer.com/payer/blue-cross-blue-shield-in-the-headlines-10-updates.html
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The Medicare bubble has burst HealthLeaders Media
(6 days ago) WEB#1 Researcher: Paxlovid is 'Game Changer' in Treatment of COVID-19. Recent research on Paxlovid shows there is "solid data on its effectiveness," a co-author of the study told HealthLeaders.
https://www.healthleadersmedia.com/payer/medicare-bubble-has-burst
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Why most older Americans who need hearing aids don't use them
(6 days ago) WEBBecause the legislation that created Medicare nearly 60 years ago specifically excluded hearing aids, those who rely on the program’s traditional coverage must pay for them out of pocket.
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UnitedHealth argues against case alleging wrongful AI care denials …
(8 days ago) WEBMedicare has a multi-step process for Medicare Advantage enrollees to appeal payment denials. Casey Ross covers the use of artificial intelligence in medicine and its underlying questions of
https://www.statnews.com/2024/05/22/unitedhealth-class-action-lawsuit-algorithm-motion-to-dismiss/
Category: Medicine Show Health
Understanding Medicare Coverage for Nursing Home Care - JD …
(8 days ago) WEBMedicare Part A Coverage Limitations and Challenges for Nursing Home Care Medicare, the federal health insurance program primarily for people 65 and older, covers a range of healthcare services.
https://www.jdsupra.com/legalnews/understanding-medicare-coverage-for-1488156/
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