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Medicare Advantage riding high as new insurers flock to sell to seniors

Medicare Advantage riding high as new insurers flock to sell to seniors

By Phil Galewitz  |  October 15, 2018

Healthcare experts widely expected the Affordable Care Act to hobble Medicare Advantage. But Since 2010, enrollment in Medicare Advantage has doubled to more than 20 million enrollees, growing from a quarter of Medicare beneficiaries to more than a third.

Week Ahead: Kicking off earnings season

Week Ahead: Kicking off earnings season

By Rachel Z. Arndt  |  October 13, 2018

UnitedHealth Group leads the pack into earnings season with its third-quarter results. In the second quarter, the company reported both higher revenue and profit.

Private Medicare insurers struggle with prescription drug plans

Private Medicare insurers struggle with prescription drug plans

By Shelby Livingston  |  October 10, 2018

The average star-ratings performance of stand-alone Part D plans, which are managed by pharmacy benefit management companies and health insurers, has bobbled up and down for years. Part D plans fared worse in 2019 than they have in the last five years.

Medicare Advantage plans shift their financial risk to doctors

Medicare Advantage plans shift their financial risk to doctors

By Phil Galewitz  |  October 08, 2018

This model—known as "full-risk" or "global risk"—is increasingly used by Medicare plans such as Humana and UnitedHealthcare to shift their financial exposure from costly patients to physician-management companies.

Medicare Advantage premiums hit three-year low

Medicare Advantage premiums hit three-year low

By Virgil Dickson  |  September 28, 2018

Average monthly premiums for Medicare Advantage will hit a three-year low next year at $28 a month, according to the CMS. Plan enrollment is expected to rise to 22.6 million, encompassing more than 36% of Medicare beneficiaries.

More Medicare Advantage upcoding could follow court ruling

More Medicare Advantage upcoding could follow court ruling

By Shelby Livingston  |  September 12, 2018

A federal judge's recent decision to vacate the 2014 Medicare Advantage overpayment rule paves the way for insurers to continue upcoding to reap higher CMS payments that could cost billions of dollars, experts said.

Doctors may sit out Medicare Advantage alternative pay model

Doctors may sit out Medicare Advantage alternative pay model

By Virgil Dickson  |  September 07, 2018

The CMS' proposed Medicare value pay experiment isn't playing well for some physicians who feel the administrative burden is too high. Their concerns come after years of lobbying to have MA plans count as an alternative pay model under MACRA.

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