Yet another study suggests that Medicare Advantage (MA) beneficiaries have less access to quality home health services. In a study comparing traditional Medicare beneficiaries and MA beneficiaries in 2019, traditional Medicare beneficiaries were more likely to utilize outpatient, inpatient and home health care services than beneficiaries in MA plans. That was the case regardless of […]
Category: Medicare Advantage
Last week, UnitedHealth Group (NYSE: UNH) defended its utilization of in-home health assessments, which are visits used widely by Medicare Advantage (MA) plans looking to fill gaps in patient care. Detractors of this type in-home visit have suggested that plans use them to up risk scores for MA members, which helps maximize reimbursement. In July, […]
Enhabit Inc. (NYSE: EHAB) CEO Barb Jacobsmeyer said Wednesday that the company would terminate its contract with the country’s largest Medicare Advantage (MA) payer, UnitedHealth Group’s (NYSE UNH) UnitedHealthcare. UnitedHealthcare accounts for 9.4 million MA beneficiaries, or 29% of all enrollees, according to the Kaiser Family Foundation. Humana Inc. (NYSE: HUM), which is the second-largest […]
Centene Corp. (NYSE: CNC) is set to pull back on Medicare Advantage (MA) in at least six states next year. As the Centers for Medicare & Medicaid Services (CMS) has made cuts to core rates over the last couple of years, insurers have put the brakes on MA expansion. Specifically, Centene will exit Alabama, Massachusetts, […]
The Helper Bees has introduced a flexible benefit card called helpful, which grants access to over-the-counter (OTC) products, groceries and a nationwide network of vetted Social Determinants of Health (SDoH) providers through a unified card experience. Helper Bees, based in Austin, Texas, is the developer of an aging-in-place platform that connects families with services in […]
Jim Rechtin took the helm as the president and CEO of Humana Inc. (NYSE: HUM) on the first of July. A month in, he’s already tasked with facing tough questions, like how the company plans to combat regulatory headwinds in Medicare Advantage (MA) and home health care. Home health providers and MA plans have continually […]
To be the beneficiaries of an overwhelming amount of home health demand, providers have to take on a larger share of Medicare Advantage (MA) patients. In the short-term, that doesn’t come off as a financially shrewd strategy, but it makes sense from a long-term perspective. Last week, I wrote about a potential “leveling off” of […]
The Centers for Medicare & Medicaid Services (CMS) isn’t letting up on cuts to home health payments, but its recent rulemaking in Medicare Advantage (MA) may end up benefiting home health providers indirectly. As MA plans become more scrutinized by regulators and lawmakers – and payment updates come with more meager increases – MA penetration […]
Health plans generally do not have great visibility into their members’ care after an acute health event. Even when they do, many aren’t confident in the post-acute care provider that’s serving their member. These findings come from a new survey of health plans conducted by the post-acute care technology company WellSky. Specifically, the survey found […]
In-home health risk assessments and in-home health evaluations are a key part of Medicare Advantage (MA) plans’ strategy. On one end, they help recognize member needs, and help connect those members to other health care services. On the other end, they help boost MA plan profits, quite considerably. A recent study published in Health Affairs […]
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