This brief provides information about Medicare Advantage plans in 2025, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
In 2025, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.
High-performing groups treat utilization with the same rigor they apply to coding and quality. Here are four key principles we’ve seen successful organizations adopt. The post Utilization: The Hidden Revenue Leak in VBC appeared first on MedCity News.
Here’s why we need stricter oversight, independent third-party testing, more rigorous research and a cultural shift in how we think about ‘natural’ remedies. The post I Trusted A Popular Supplement — It Shut Down My Liver appeared first on MedCity News.
Element and Siftwell provide insights to help providers close care gaps for complex populations
Fortina Hernández is called “the one who knows it all.” For more than two decades, the community health worker has supported hundreds of families throughout southeast Los Angeles by helping them sign up for food assistance, sharing information about affordable health coverage, and managing medications for their chronic illnesses. She’s guided by the expression “an…
A few days after a harrowing cosmetic surgery procedure, Erin Schaeffer said, she woke up with fluid leaking from an open wound in her stomach. Schaeffer went on to spend a week in a Florida hospital battling a severe infection after a type of tummy tuck and liposuction at the Jacksonville branch of Sono Bello,…
Two U.S. representatives have introduced the Prompt and Fair Pay Act, a bipartisan bill that would require Medicare Advantage plans to reimburse providers at least the same rates as traditional Medicare, as well as pay claims more promptly. Providers and industry groups have welcomed the proposal, citing mounting financial strain and growing concerns over care…
National Bureau of Economic Research study says price increases after these mergers are driven by reduced competition
Numerous insurers — including Oscar Health, Elevance Health, Molina Healthcare and Centene — have announced they’re cutting or withdrawing their earnings guidance for the year. And the individual market seems to be the culprit. The post Why Several Insurers Are Cutting/Withdrawing Their Earnings Guidance appeared first on MedCity News.