Forty Medicare Advantage insurers received higher star ratings after the Centers for Medicare and Medicaid Services was forced to revise the 2024 quality scores.
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Unless this translates into higher reimbursements, providers will still struggle with Medicare Advantage paying 85% of traditional Medicare…driven by denials, down coding, bad debt, and excessive administrative burden….forcing many hospital systems to reevaluate their willingness to participate with MA going forward. Learn more about how to optimize your Medicare Advantage Contracts👉 https://lnkd.in/gRB3rMw3 #EllsworthConsulting
Forty Medicare Advantage insurers received higher star ratings after the Centers for Medicare and Medicaid Services was forced to revise the 2024 quality scores.
Elevance, Scan boosted in Medicare Advantage stars redo
modernhealthcare.com
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A recent study by ATI Advisory found that people in Medicare Advantage and regular Medicare are quite similar in terms of health and function. The fascinating part is that, on average, individuals in Medicare Advantage spend approximately $2,400 less on costs and premiums than those in regular Medicare. 🤯 Also, if you're client is on a tight budget without Medicaid, going for Medicare Advantage reduces the chances of them struggling with healthcare costs by HALF compared to regular Medicare. Read the full report by clicking the link below. https://lnkd.in/e-62tcaq #MedicareInsurance #MedicareInfo
MA-Cost-Protections-Data-Brief-2023.pdf
atiadvisory.com
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The Centers for Medicare & Medicaid Services issued the CMS Interoperability and Prior Authorization Final Rule, continuing its efforts to encourage interoperability and availability of electronic #healthinformation. Read about the new requirements established by the rule in this #healthcare alert by #policy advisor Miranda Franco. #healthcarepolicy
CMS Releases Interoperability and Prior Authorization Final Rule | Insights | Holland & Knight
hklaw.com
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The Centers for Medicare & Medicaid Services' final Access and Managed Care rules reflect the biggest regulatory changes to Medicaid and CHIP in nearly a decade. Here's how states should respond.
How States Should Respond to the Final Medicaid Access and Managed Care Rules
mathematica.org
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EXECUTIVE CONSULTANT | STRATEGIC INITIATIVES EXPERT | Board Member for University of Southern Florida, MUMA College of Business - Trusted and respected Managed Care, IT and M&A Executive with transferrable expertise
D-SNP is the final frontier in Government Services. Medicare and Medicaid on their own are challenging, but this plan type has increasing coordination requirements. With more than a decade in DSNPs, Medicare and Medicaid, I can help guide you to an optimized HBR, success in compliance and growth in membership. https://lnkd.in/eJPm6r_r
10 Things to Know About Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) | KFF
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More big news for Medicare Advantage: The Centers for Medicare & Medicaid Services (CMS) agreed to recalculate MA quality ratings after a series of court decisions found CMS improperly calculated star ratings for the 2024 plan year. The new CMS guidance would recalculate quality ratings industry-wide, likely increasing bonus payments for many insurers. As the landscape of MA quality ratings continues to evolve, we stand ready to support MA plans in navigating these changes and achieving excellence in member care. Read more: https://bit.ly/3xkfNDv #HealthcareInnovation #HEDIS2024 #MedicareAdvantage #QualityImprovement #HealthTech
CMS confirms Medicare Advantage quality ratings to get new calculations
fiercehealthcare.com
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Did you know that people dually eligible for #Medicare and #Medicaid must choose from 35 Medicare Advantage plans on average? Medicare Plan Finder is CMS’s web-based tool to help the Medicare population navigate their health plan choices, but the tool is geared toward non-dual eligible people. Those who are dually eligible often must sift through multiple pages and more than a dozen health plans before seeing the first Medicare Advantage dual eligible special needs plan (D-SNP), and may see incomplete or even inaccurate information for their specific circumstances. Take a look at ATI’s recent blog post on two changes Centers for Medicare & Medicaid Services can implement to meaningfully improve Medicare Plan Finder for people who are dual eligible, their caregivers, and insurance counselors: https://lnkd.in/eRgASmSg Many thanks to Community Catalyst, Medicare Rights Center, Association for Community Affiliated Plans (ACAP), Justice in Aging , SNP Alliance, and Kenton Johnston of the University of Washington St. Louis Medicare Innovation Research Lab for their input on this blog.
Two Ways CMS Can Meaningfully Improve Medicare Plan Finder for People Who Are Dual Eligible | Resources for Innovations in Care | ATI Advisory
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The CMS intends to strengthen its supervision of health insurers involved in the Medicare Advantage program, driven by concerns about care rejections, access challenges and bad coding practices that inflate program expenses. The CMS deputy administrator spoke of the agency's dedication to enhancing value, services and information for beneficiaries and taxpayers, while tackling concerns around excessive payments and claims of profiteering among Medicare Advantage providers. https://hubs.li/Q024VwxC0 #lifesciences #healthcareindustry #datainsights
CMS to get ‘tougher’ on Medicare Advantage, official promises
healthcaredive.com
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