Subscription Required

Only paid subscribers* to Medicare Advantage News can access this Web portal with three years of back issues, searchable article archives and other valuable resources.

Subscribers to Medicare Advantage News receive

  • 24 biweekly issues (8 pages) of timely news and strategic analysis for MA Plans … leading the industry since 1994, delivered First Class by U.S. Mail and electronically
  • Special E-Alerts when timely news breaks
  • Access to your subscriber-only Web page with:
    • Searchable archives of past articles,
    • Convenient library with PDFs of back issues,
    • Recent stories of interest grouped for convenient reading
    • Bonus reports for subscribers, and
    • Regular postings from your editor.
View a sample and get more information
June 8, 2017

Recent Stories

From Medicare Advantage News - The Medicare Advantage and Prescription Drug Plan bid submission process that ended June 5 involved the usual tinkering with benefits and premiums for the sake of financial stability, but such changes were for the most part infrequent and modest, several actuaries and consultants tell AIS Health. And while MA plans didn’t have to prepare for the increased use of encounter data in risk scores for 2018, there was some worry about the fact that a complete third round of risk score data wasn’t available until after bids were due, some report. Read more

In order to ensure that Medicare beneficiaries have access to “meaningful benefit… Read more

At a time when congressional leaders are notoriously at odds over health… Read more

CMS has long held that failing to meet required timeframes for processing… Read more

From the Editor

Welcome to your Medicare Advantage News subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles, links to government documents and more!

Please e-mail me with your comments on the last issue of Medicare Advantage News, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

May 2, 2017
Molina Fires CEO, CFO in Light of Earnings Disappointment

Molina Healthcare fires CEO, CFO in light of “disappointing financial performance”; will report earnings after market close today. http://tinyurl.com/mgy7a2w

April 3, 2017
2018 Final Rate Notice Includes Revision to EDS Use, RFI on Potential Innovations

While the 2018 Final Payment Notice and Call Letter for Medicare Advantage and Part D plans posted on April 3 carried over many of the same policies from the preliminary notice issued in February, one notable revision made by CMS pertained to its use of encounter data in calculating risk scores. In response to "extensive" feedback from plans about the payment impact associated with the ongoing transition to the encounter data system (EDS), CMS scaled back its earlier proposal of using a blend of 75% risk adjustment payment system (RAPS) data and 25% EDS data to a mix of 85% RAPS and 15% EDS.

The final notice also indicated that plans will see a slightly better improvement in reimbursement of 0.45% when compared with the modest pay hike of 0.25% included in the Advance Notice published two months ago. Factoring in an expected diagnosis coding trend of 2.5% and a rebasing adjustment of 0.3% that CMS did not include in its preliminary projections, CMS estimated that plans could see their payments improve by 2.95% on average, compared with its earlier estimate of 2.75%.

Moreover, CMS for the first time used the notice to make a request for information soliciting ideas from the public on ways CMS can bring more transparency, flexibility, program simplification and innovation to the MA and Part D programs that could be incorporated into future regulatory, subregulatory, policy, practice and procedural changes from the agency. CMS officials during a Feb. 3 press call indicated this request is a reflection of the new administration's "openness" to innovation in the MA space.

View the final rate notice and RFI here.

March 22, 2017
Bonus Insight Reports for Subscribers

Several special reports covering key issues of concern to today’s health care executives are now available in your Subscriber Library. These original reports from the AIS Health editorial team are filled with practical strategies for managing Medicare patients’ pharmacy and medical costs. Access them at https://aishealth.com/newsletters/medicareadvantagenews/bonus-insight-re....

It's quick and easy to sign up for FREE access to AISHealth.com!

Why do I need to register?