The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.

On January 26, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2027 Advance Notice of Methodological Changes ...

Medicare Advantage (MA) is privately administered health care insurance for seniors and persons with disabilities. The program has grown rapidly and now covers more than half of Medicare-eligible ...

The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for calendar year 2027, which the agency ...

1. Part 1 of the 2021 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies proposes changes to the Part C risk adjustment model and ...

Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...

Health insurers are warning that flat Medicare Advantage rates, as proposed by the Trump administration late Monday, would likely force them to take a deep look at the benefits they offer. The news ...

Morgan Stanley flagged a new Medicare Advantage policy overhang, saying Humana’s "disproportionate" exposure could pressure ...

The AHA commented today on the Centers for Medicare & Medicaid Services’ proposed rule that would make changes to the Increasing Organ Transplant Access Model beginning July 1. The AHA expressed ...

Leavitt Partners: What major insurers have to say about CMS’ risk adjustment program The Patient Protection and Affordable Care Act (ACA) introduced restrictions on underwriting and new federal ...

Medicare Advantage plans are getting a 5% payment increase, which is above the anticipated 4.3% released in the Advance Notice. The Centers for Medicare and Medicaid Services issued the rate ...