Tag: Medicare Advantage

Can-automation-solve-the-prior-authorization-problem

Can Automation Solve The Prior Authorization Problem?

In the latest American Medical Association (AMA) survey, 93% of physicians said prior authorizations delay patient care, and 82% said the process is so complicated that it causes patients to abandon treatment altogether. Prior authorization (PA) remains the top regulatory burden for most health care and medical professionals, often delaying or preventing access to essential […]
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CMS-Aims-To-Streamline-Prior-Authorization

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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Value-Based-Payment-Models-Can-Limit-Healthcare-Spending

Value-Based Payment Models Can Limit Healthcare Spending

Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
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Congress-to-Help-Primary-Care

Time is Running Out for Congress to Help Primary Care

Time is running out for Congress to take action on pending legislation dealing with issues that would help primary care across the United States. Six physician groups representing 590,000 doctors across the country sent a joint letter again urging congressional leaders to vote – soon – for bills relating to Medicare reimbursements, prior authorizations, children’s […]
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Medicare-Advantage-Bill-Response-To-Complaints

The Medicare Advantage Bill Was Crafted In Response To Complaints

The bill was crafted partly in response to rising complaints among seniors over aggressive marketing practices for Medicare Advantage plans. U.S. Sens. Maggie Hassan, D-N.H., and Dr. Roger Marshall, R-Kansas, have introduced the bipartisan Medicare & You Handbook Improvement Act, which is meant to ensure that when seniors assess their Medicare coverage options, they have the necessary […]
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Administrative-Policies-Overburdening-Providers

Administrative Policies Are Overburdening Providers

Some commercial health insurers are using policies that can delay patient care and create burden for providers, causing relationships with hospitals to worsen, according to a survey by AHA. The association fielded responses from more than 200 hospitals in 2019 and from 772 hospitals between December 2021 and February 2022, creating data that both predates […]
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Is-Medicare-Advantage-Really-a-Disadvantage

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
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