MA enrollees receive less intensive end-of-life care, study finds
By
Donna Shryer
Jul 21, 2024
A new study published in JAMA Health Forum reports that Medicare Advantage (MA) enrollees receive less intensive end-of-life care compared to those in traditional Medicare (TM). To identify this conclusion,...
Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
By
Josh Henreckson
Jun 26, 2024
The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional...
Providers express support for MA prior authorization reform bill
By
Donna Shryer
Jun 16, 2024
Nursing home and senior living providers on Friday praised the newly introduced Improving Seniors’ Timely Access to Care Act, which would address the longstanding issue of prior authorization required...
Sector, consumer advocates vent shared frustrations on Medicare Advantage lack of transparency to CMS
By
Josh Henreckson
Jun 02, 2024
Long-term care leaders and consumer advocates — often at odds over nursing home policy — have voiced their shared frustrations about Medicare Advantage plans to the Centers for Medicare & Medicaid...
A Medicare Advantage fix: What took so long?
By
James M. Berklan
Apr 12, 2024
Providers hoping that policy makers might some day show some backbone when dealing with Medicare Advantage plans can take heart. Well, at least a little.
Understanding facility, peer data called crucial to better Medicare Advantage negotiations
By
Josh Henreckson
Mar 27, 2024
Nursing homes have historically had little leverage in negotiations with Medicare Advantage plans, even as MA has come to cover an ever-larger number of skilled nursing beneficiaries.
Baseline proficiency for success with managed care payers
By
Susie Mix
Mar 11, 2024
Setting up a building with proficiencies in working with managed care payers is a key to success at this midpoint of the 2020s. Fifty-one percent of Medicare-eligible Americans are covered by Medicare...
CMS official to providers: Help us capture data to drive Medicare Advantage reforms
By
James M. Berklan
Mar 07, 2024
The increased use of health data and providers’ own voices should be considered among the best tools available for achieving change in a system that increasingly relies on Medicaid Advantage and other...
Also in the News for Tuesday, Mar. 5, 2024
By
Kimberly Marselas
Mar 05, 2024
On the Move: Consulate appoints new COO … Former CMS head says MA plans are gaming the system … Too many skilled nursing websites show performance, access problems, audit warns … Legionaire’s case...
Can Medicare Advantage be redeemed?
By
Jean Wendland Porter
Feb 06, 2024
I just got back from vacation and didn’t have to think about this for a whole week. But there’s no place like home. For a whole week, I didn’t have to worry about chores, obligations, or how Medicare...