SCAN Health Plan will offer its senior-first Medicare Advantage Plans in 17 markets across three states starting in 2022. SCAN currently provides senior-focused Medicare Advantage plans to 220,000 Californians and aims to reach even more seniors by extending its offerings to Alameda and San Mateo counties. The payer had not offered plans in states other […]
Dive Brief: In a win for providers, CMS dropped a requirement that would have forced hospitals to disclose their contract terms with Medicare Advantage plans from its final inpatient pay rule for 2022 released Monday. The rule bumps payment for inpatient services by 2.5%, which will result in hospitals getting $2.3 billion more than this […]
MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]
ACHP provides several steps that will leverage the advancements of the Affordable Care Act and increase access to high-quality coverage and care. The Alliance of Community Health Plans (ACHP) released recommended steps to build on the success of the Affordable Care Act (ACA) and enhance and expand coverage in the individual health insurance market. First, […]
Dual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably lower than dual eligibles under fee-for-service (FFS), according to an Avalere Health study released Tuesday evening. Dual eligible Medicare Advantage (MA) populations averaged healthcare […]
Proposed rules also include new payment models. The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks issuing the proposed payment rules for 2020 and making some other announcements. Here is an update on other regulatory activities of interest. On April 22, 2019, the CMS Innovation Center announced the […]