by Jordana Choucair | Feb 3, 2023 | Payers
A new Kaiser Family Foundation analysis found that Medicare Advantage (MA) plans denied two million (six percent) of the 35 million prior authorization requests for health care services in whole or in part in 2021. The analysis also finds that, in general, insurers...
by Jordana Choucair | Feb 2, 2023 | Payers
The Centers for Medicare & Medicaid Services (CMS) released the advance notice of methodological changes for Medicare Advantage (MA) capitation rates and payment policies for MA and Part D. The notice includes a 2.09 percent rate increase and a 1.03 percent...
by Jordana Choucair | Feb 1, 2023 | Payers
Blue Shield of California announced it is partnering with Accolade to launch a new virtual-first health plan. Beginning April 1, members who choose the Virtual Blue plan will be able to access a slew of virtual health services – including 20 different types of...
by Jordana Choucair | Feb 1, 2023 | Inequities and SDOH, Payers
Kaiser Family Foundation (KFF) released two new analyses exploring the demographics of the 12.5 million dual eligibles and the spending associated with this population. According to the analyses, 87 percent of dual eligibles had an income of less than $20,000 in 2020,...
by Jordana Choucair | Jan 31, 2023 | Payers
The Biden administration finalized a rule that will implement audits of Medicare Advantage (MA) insurers in an effort to identify and recover overpayments. Medicare projects to get back $479 million for audits of 2018 plans, and the government expects to recoup $4.7...
by Jordana Choucair | Jan 31, 2023 | Payers
A new issue brief from the Commonwealth Fund found that the U.S. continued to far outspend other developed nations while seeing worsening health outcomes in the first year of the pandemic. According to the brief, the U.S. spent nearly $12,000 on health care per...
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