Medicare Advantage and Part D

From Medicare Advantage News - Medicare Advantage plans still generally are reporting strong earnings, aided by continued low medical-services utilization, based on figures and comments on first-quarter results of publicly held firms presented late last month and early this month. But several of the plan sponsors also pointed to storm clouds on the horizon in the form of not only payment-rate reductions but also the industry fee that starts in 2014 and the expected return of higher utilization patterns. The prime example of all of those trends may be Humana Inc. Read more

From Medicare Advantage News - Medicare Advantage plan sponsor Universal American Corp. is building a potentially substantial new business helping rural providers start MA plans of their own, sometimes in areas where the company itself has MA operations. Universal American will be supplying capital, taking risk and performing insurance-related functions in return for 50% of the net profits in an approach linked partly to aiding the providers as managed care business for Medicare-Medicaid dual eligibles… Read more

Medicare Advantage & Part D Blog

By James Gutman - June 14, 2013
To rephrase an old aphorism, there are lies, damned lies and government figures on Medicare Advantage plan enrollment. And each of them can be misleading if the underlying assumptions aren’t challenged. A new Kaiser Family Foundation (KFF) study confirms, with the aid of CMS data, the strong recent...
By James Gutman - June 6, 2013
It probably didn’t surprise many people late last month when Massachusetts pushed back the start date of its CMS-backed Medicare-Medicaid dual eligibles demonstration initiative again, this time to Oct. 1. The program, which last August became the first of six that CMS has approved for the huge...
By James Gutman - May 31, 2013
Preparing Medicare Advantage and Part D plan bids for the following year always is difficult, but this year it may be close to impossible. The final decisions on 2014 service areas, benefits and premiums that MA and Part D sponsors undoubtedly will be huddling over this weekend in preparation for...

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