Tag: Medicare Advantage

MIRAMAR, Fla. – onehome, a leader in post-acute home-based care, is partnering with Devoted Health, a Medicare Advantage company, to expand care to Devoted Health's members in Arizona, Ohio and San Antonio, Texas. The partnership brings enhanced care into members' homes, enabling them to receive health care, including infusion services, wound therapy and durable medical equipment, at home. "Our members' health and quality of life depend on access to safe and...

WASHINGTON and HARTFORD, Conn. – Avalere, an independent health care research and consulting firm, has found a major reduction in the total cost of care for patients managed by CareCentrix through reduced emergency room visits, hospital utilization and hospital readmissions.  Avalere found that the total cost for Medicare Advantage members was 44% lower in the CareCentrix-managed population during the initial 90 days following discharge and 27% lower twelve months after...

WASHINGTON – The Better Medicare Alliance, a research and advocacy organization supporting Medicare Advantage, is airing a new television ad on broadcast networks in Washington, D.C., and cable news channels nationwide. The 60-second spot highlights MA’s preparedness in the face of health care challenges. “The COVID-19 pandemic has shown just how responsive and nimble Medicare Advantage is and how important it is to the health and wellbeing of beneficiaries,”...

In November, at the height of open enrollment season, U.S. Rehab’s Dan Fedor warned complex rehab providers about the Medicare Advantage plans that were being promoted by celebrities in TV commercials. The first thing providers need to know about these plans: what they’re promising Medicare beneficiaries. “A lot of (MA plans) are trying to lure (beneficiaries) from traditional Medicare to their MA plan,” said Fedor, director of reimbursement and education for U.S. Rehab,...

WASHINGTON - The Medicare Advantage average monthly plan premium is expected to decrease 11% to $21 in 2021, CMS has announced. Since 2017, the average monthly plan premium has decreased 34.2%, according to the agency, saving beneficiaries nearly $1.5 billion in costs. “This is the lowest that the average monthly premium for a Medicare Advantage plan has been since 2007,” CMS state. “In some states, including Alabama, Nevada, Michigan and Kentucky, beneficiaries will see average...

Dan_Fedor.jpg Many Medicare beneficiaries are being enticed by celebrities on TV to select a Medicare Advantage (MA) plan over original Medicare fee for service (FSS) with all the standard benefits of Medicare at a lower out-of-pocket cost. These plans often state they provide additional benefits, such as gym memberships, transportation and eyeglasses, so how can they provide more benefits with a lower cost? Seems too good to be true, doesn't it? How can these private, for-profit insurance...

WASHINGTON - CMS will increase average payments for health insurers that manage Medicare Advantage plans by 3.4% for 2019, the agency announced on April 1. CMS initially proposed a 1.84% increase, according to news reports. The agency will also make a number of policy changes to MA plans, including codifying key aspects of the Star Ratings system and revising the regulations controlling maximum out-of-pocket limits.

WASHINGTON - The standard monthly premium for Medicare Part B enrollees will be $134 for 2018, the same as 2017, CMS has announced.Some beneficiaries who were protected from Part B premium increases in prior years will have increases in 2018, but they will be offset by the increases in their Social Security benefits next year, CMS says.“Medicare's top priority is to ensure that beneficiaries have choices for affordable, high-quality care that fit their needs,” said CMS Administrator Seema...

WASHINGTON - Medicare Advantage premiums will remain stable and for the seventh straight year enrollment is projected to increase to a new all-time high, CMS announced Sept. 22. The average monthly premium will decrease by $1.19, from $32.59 in 2016 to $31.40 in 2017, about 4%. The majority of Medicare Advantage enrollees (67%) will experience no increase in premiums. Enrollment will increase to 18.5 million in 2017, a 60% increase from 2010. Thirty-two percent of all Medicare enrollees will be in...

WASHINGTON - The Government Accountability Office isn't pleased with CMS's progress in recovering substantial amounts of improper payments from Medicare Advantage organizations. The agency currently uses risk adjustment data validation audits to recover improper payments in the MA program. The GAO found that CMS's methodology does not result in the selection of contracts for audit that have the greatest potential for recovery of improper payments. The GAO also found “substantial delays”...