From Medicare Advantage News - There are significant health care disparities, both in terms of access and results, between minority groups and whites in Medicare Advantage plans, according to the first-ever CMS release of data stratified by contract for race and ethnicity in MA. The data, which were released April 19 and are slated to be issued annually, show “we have a number of measures that we need to do a better job” on, Cara James, Ph.D., director of the CMS Office of Minority Health, tells MAN. But a close look at the 2013 and 2014 quality measures that CMS and its research partner RAND Corp. Read more
From Medicare Advantage News - An insurer trade group’s new pilot project on verifying provider-directory information may not only improve the acknowledged inaccuracy of much current provider-directory information, but it also may reduce the need for burgeoning CMS efforts to crack down on directory errors in Medicare Advantage. However, neither the pilot unveiled by America’s Health Insurance Plans (AHIP) on March 22 nor the Provider Network Accuracy (PNA) monitoring pilot that CMS said in a March… Read more
From Medicare Advantage News - While Medicare Advantage products generally have performed strongly recently, that has not been the case in at least some aspects for two of the industry’s former stalwarts, Humana Inc. and Universal American Corp. In both cases the culprit may be related to aggressiveness that has led to high medical loss ratios (MLRs) in some markets, and the setbacks come despite relatively strong star-ratings performance. Read more
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