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News
Coming Medicaid plan rules will set new access standards
By Virgil Dickson | October 28, 2014 | Basic Web Basic Web Subscription Details
CMS officials say they're on track for a January 2015 release of sweeping new Medicaid managed-care regulations intended to ensure that beneficiaries get timely access to care and better integration of services.
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News
Insurance execs vow to fight further cuts to Medicare Advantage
By Paul Demko | October 08, 2014 | Basic Web Basic Web Subscription Details
Health insurers are justified in raising alarms about the harmful effects of Medicare Advantage program cuts, executives with two of the country's largest health plans said Wednesday at a Washington forum. They promised to fight further reductions in spending on the popular coverage program for...
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Magazine
How healthcare's Washington lobbying machine gets the job done
By Paul Demko | October 04, 2014 | Print Magazine Print Magazine Subscription Details
Providers, insurers, drug and device manufacturers, and the major trade associations are among the largest funders of the inside-the-Beltway influence industry. This year, they're on pace to spend nearly $500 million seeking to advance policies or avoid setbacks on issues crucial to their interests.
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News
Fewer Medicare Rx plans offered for 2015: Avalere study
Paul Demko | September 22, 2014 | Basic Web Basic Web Subscription Details
The number of prescription drug plans available to seniors will drop by roughly 14% for 2015, according to an analysis of Medicare filings by Avalere Health. The number of Medicare Part D plans nationwide will decrease from 1,169 this year to 1,001 in 2015.
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News
CMS expects Medicare Advantage 2015 premiums to be flat for most enrollees
Paul Demko | September 18, 2014 | Basic Web Basic Web Subscription Details
The average monthly premium for Medicare Advantage plans in 2015 will be $33.90—an increase of $2.94, or 9.5%, over the current year. But as a result of more individuals seeking out lower-cost plans, the CMS estimates that the average premium hike will actually be $1.30 per month. And the...
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Vital Signs
MedPAC disputes that half of new Medicare enrollees pick Advantage
Paul Demko | September 15, 2014
Half of new Medicare beneficiaries are opting for private plans over the traditional fee-for-service program. That's a statistic that's been reported by Modern Healthcare and other publications in recent years. Healthcare consultant John Gorman, one of the foremost experts on Medicare Advantage,...
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News
Reform Update: Familiar talking points on Medicare emerge in tight congressional contests
Paul Demko | September 12, 2014 | Basic Web Basic Web Subscription Details
Healthcare has not been at the forefront of Iowa's tightly contested Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst. But last week, the National Republican Senatorial Committee started running an ad attacking Braley's stance on Medicare. It is also running...
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News
Froedtert seeks co-ownership of Ascension health-plan affiliate
Bob Herman | August 15, 2014 | Basic Web Basic Web Subscription Details
Froedtert Health, an academic medical center based in Milwaukee, is in negotiations to buy a 50% stake in Network Health, a health insurance company based in Menasha, Wis.
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Vital Signs
Few Medicare beneficiaries enroll in drug-management program
Paul Demko | August 07, 2014
Fewer than half of Medicare beneficiaries eligible for a program designed to review medication usage among those with high drug-utilization rates were enrolled in 2012, according to a CMS data analysis from Avalere Health.
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News
Universal American's zeal for ACOs is fading
Melanie Evans | July 29, 2014 | Basic Web Basic Web Subscription Details
Insurer Universal American, the largest operator of Medicare accountable care organizations, has exited three ACOs and may drop more as the company sheds poorly performing or fringe businesses, said executives with the publicly traded insurer.
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