Medicare Advantage and Part D

From Medicare Advantage News - As CMS carries out a new policy of reviewing Medicare Advantage plans’ entire provider networks for adequacy if they request service area expansions, MAN has learned that plans are dealing with a stricter-than-ever exceptions process and in some cases are having to drop legacy counties in order to expand. Read more

From Medicare Advantage News - When it comes to managing risk and closing gaps in care, the solution isn’t always as simple as targeting the costliest members. Health plans and their vendor partners can implement tailored strategies that include sharing risk with providers, leveraging community partners and using data to identify those members at the highest risk for noncompliance and costly claims, according to two speakers who gave separate presentations at the Medicare Advantage and… Read more

Medicare Advantage & Part D Blog

By Lauren Flynn Kelly - September 8, 2016
In that very rare intersection of my current job as a health care reporter and editor of AIS’s Medicare Advantage News and my former life as a soap opera journalist (yes, there is such a thing!), Cigna Corp. is using a handful of TV actors in a new advertising campaign aimed at encouraging people...
By Lauren Flynn Kelly - July 14, 2016
At sessions of the 12th Annual Government Health Care Congress held July 12 and 13 in Tysons Corner, Va., two central themes rang out: integration and value. Whether it comes to coordinating post-acute care for seniors enrolled in Medicare or meeting the more complex needs of the dual-eligible...
By Lauren Flynn Kelly - June 16, 2016
When Medicare accountable care organizations and the Medicare Shared Savings Program (MSSP) were established in 2011 as a result of the Affordable Care Act, some industry observers predicted a large-scale movement of ACOs building their own risk-bearing entities and forming their own Medicare...

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