Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
This brief provides information about Medicare Advantage plans in 2025, including premiums, out-of-pocket limits, supplemental…
Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
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.
Medicare Advantage in 2025: Enrollment Update and Key Trends
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.
Utilization: The Hidden Revenue Leak in VBC
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.
I Trusted A Popular Supplement — It Shut Down My Liver
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.
California Looked to Them To Close Health Disparities, Then It Backpedaled
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…
Cosmetic Surgeries Led To Disfiguring Injuries, Patients Allege
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,…
Bipartisan Bill Seeks to Establish Parity Between MA & Traditional Medicare Payments
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…
Why Several Insurers Are Cutting/Withdrawing Their Earnings Guidance
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.
It’s Time to Make Lifestyle Interventions Standard in Oncology
A growing body of evidence shows that structured lifestyle interventions such as physical activity, nutrition, and stress management aren’t just helpful; they also reduce cancer recurrence, improve quality of life, lower mortality, and even decrease healthcare costs. The post It’s Time to Make Lifestyle Interventions Standard in Oncology appeared first on MedCity News.
When Listening Could Save a Life: The Human Cost of Medical Gaslighting
Let’s be honest. Clinicians are taught to reduce unnecessary care. But there’s a razor-thin line between avoiding unnecessary tests and failing to believe a patient’s symptoms. The post When Listening Could Save a Life: The Human Cost of Medical Gaslighting appeared first on MedCity News.
