Best Practices: Building better supports for dementia

Best Practices: Building better supports for dementia

By Maureen McKinney  |  September 26, 2015

CareMore, a Medicare Advantage plan headquartered in Cerritos, Calif., has seen significant safety gains and fewer ER visits with its team-based Brain Health program for dementia patients and their caregivers.

Senators grill CEOs of Aetna, Anthem over competitive effects of deals

Senators grill CEOs of Aetna, Anthem over competitive effects of deals

By Bob Herman  |  September 22, 2015

Aetna CEO Mark Bertolini and Anthem CEO Joseph Swedish told senators Tuesday that local and national health insurance markets would remain competitive if the federal government approved their pending transactions. Other witnesses expressed sharp skepticism.

Average Medicare Advantage premiums to decline in 2016

By Bob Herman  |  September 21, 2015

The average Medicare Advantage premium for 2016 will be $32.60 a month, a drop of 31 cents a month, or just under 1%, from this year, the CMS said Monday. Almost 3 in 5 Advantage beneficiaries will not face a premium increase next year.

CMS cost-sharing test viewed as model

CMS cost-sharing test viewed as model

By Bob Herman  |  September 05, 2015

A new test within the Medicare Advantage program will lower out-of-pocket costs for chronically ill patients who seek high-value services and providers.

Some states iffy on extending 'duals' demo

By Virgil Dickson  |  September 04, 2015

The Obama administration says it needs more time to evaluate a large-scale test coordinating benefits and care for low-income and disabled Americans. The 12 participating states appear willing to stick with it, but the two largest expressed significant reservations.

What Medicare's value-based insurance test could mean for commercial plans

By Bob Herman  |  September 03, 2015

Supporters hope a new Medicare Advantage experiment offering lower out-of-pocket costs for high-value services and providers will become a template for health plans with sizable cost-sharing, which have become the standard offering from employers and insurers.

Whistle-blower in $320 million SCAN case not entitled to cash

By Lisa Schencker  |  August 31, 2015

The whistle-blower whose case led to a whopping $320 million settlement between the government and SCAN Health Plan in 2012 is not entitled to any of that cash, a federal judge has ruled. Some say the decision could lead to fewer whistle-blowers bringing cases against Medicare Advantage plans.

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