CMS’ planned changes in the Medicare Advantage (MA) capitation rate methodology and risk adjustment methodology, which will lead to a projected payment rate increase of around one percent in 2024...
Diane Archer
Who’s enrolling in Medicare Special Needs Plans?
Becker’s Payer Issues reports that Medicare Advantage Special Needs Plans–health plans for people with Medicare and Medicaid–are the fastest growing segment of the Medicare...
Rural hospitals need government help to survive
No American should have to travel long distances to get to a hospital, especially in an emergency. But, as more hospitals are being swallowed up into hospital systems and profitability becomes a...
Unless you have Medicare, surprise ambulance bills are common
Unless you have Medicare, surprise ambulance bills continue to be a serious concern for most Americans, even Americans with health insurance. Often the local ambulance is out of network and comes...
Don’t rely on Mark Cuban’s Cost Plus Drugs for the...
I promoted Mark Cuban’s Cost Plus Drugs a while back as a way to get low-cost generics. As it turns out, Darius Tahir reports for Kaiser Health News that Cost Plus Drugs does not always offer...
Medicare Advantage ads are improperly embedded in people’s...
Medicare Advantage plans are now advertising on people’s electronic health record portals, reports Cheryl Clark for MedPage Today. The Centers for Medicare and Medicaid Services (CMS), which...
Medicare Advantage enrollees face higher likelihood of hospital...
Paige Minemyer reports for Fierce Healthcare that hospitals treating Medicare Advantage enrollees faced a higher likelihood of claim denials last year than the year before. Medicare Advantage plans...
Pharmacy Benefits Managers continue to drive up costs
Most people likely do not even know what a Pharmacy Benefit Manager (PBM) is. PBMs allegedly add value to your prescription drug benefit through negotiating drug discounts with pharmaceutical...
Republicans plan to cut Social Security, President Biden should...
[This article was originally published in Common Dreams on February 8, 2023] Last night, President Joe Biden called out Congressional Republicans for their plans to cut Social Security and...
Will Republicans and Democrats agree to cut waste in Medicare...
Republicans and Democrats in Congress claim that they don’t want Medicare cuts. As we learn more, we find that “cuts” can mean different things to Republicans and Democrats...