Star Ratings and Member Experience: Two Sides of the Same Coin
The challenge? Maintaining high Star Ratings or improving upon existing ratings gets increasingly difficult over time.
Report: Payers Aren’t Providing an Adequate Digital Experience
About 32% of health insurance sites and apps “don’t meet the foundational level of functionality and intuitive organization of information,” according to a new J.D. Power report.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Report: How MA Plan Design Affects Utilization, Health Equity
A new study found that enrollees with zero-premium MA plans are three times as likely to be non-White compared to other MA enrollees and traditional Medicare enrollees.
Insurer Advocacy Orgs Slam Final MA, Part D Rate Announcement
America’s Health Insurance Plans, the Better Medicare Alliance and the Association for Community Affiliated Plans all came out against CMS’ final 2025 Medicare Advantage and Part D rate announcement.
Post-Acute Care and Enablement of the Home, An Industry in Flux
Collaboration across key stakeholders, including home health agencies, providers, patients, health plans, and post-acute care solution providers will be critical to fully enabling the home as a preferred place of care.
Quantum Health Dips into Medicare Advantage Market
Quantum Health is now offering a navigation service for Medicare Advantage plans. The company has traditionally served employers.
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A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Does Chronic Disease Management in Medicare Advantage Need a ‘Retail’ Makeover?
Adopting consumer strategies from leading retailers can give MA plans an edge in an increasingly competitive market filled with new entities while improving quality, reducing cost, and improving member loyalty.
“The Name May Be ‘Neue’ but Their Problems are Old”: Will Bright Health’s Rebrand Save It?
Bright Health Group recently announced that it is adopting NeueHealth as its corporate brand name after it shed its insurance business and is focusing on its value-based consumer care business. But getting rid of the Bright Health name doesn't get rid of its financial problems, experts say.
Why Experts Saw Cano Health’s Bankruptcy Coming From A Mile Away
Cano Health filed for bankruptcy this week — about three years after going public $4.4 billion SPAC merger. The industry reacted without surprise, with experts calling the bankruptcy a direct result of mismanagement, a quixotic growth strategy and poor market selection.
Will We Close the Medicare Advantage Primary Care Gap in 2024?
Medicare Advantage patients without a primary care physician are perhaps the greatest risk to health plans in 2024. Health plans must adopt best practices to reach and engage MA patients, especially those with multiple, complex conditions. Here are six best practices to consider.
Maximize Revenue and Patient Care with Strategic Weight Loss Management
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
One VC Firm’s 5 Healthcare Predictions for 2024
Executives at LRVHealth expect to see a continued focus on generative AI, increased enrollment in Medicare Advantage and more in 2024.
Who Really Benefits From Medicare Advantage Plans?
Health systems have been increasingly dropping MA contracts, saying that they cause their organizations to lose too much money and result in dangerous patient care delays. To mitigate this issue, experts think large MA plans need to delegate more utilization management duties to health systems rather than handling it themselves.
4 Senators Urge CMS To Collect, Publish More Data on MA Plans
In a letter to CMS, four senators asked for better data collection on the practices of Medicare Advantage plans, including when it comes to prior authorization.
Expert: The Rumored Humana/Cigna Combination Makes Sense
With Cigna mostly focused on the commercial market and Humana mostly focused on the Medicare Advantage market, the rumored combination rumors check out, according to one industry expert.
Report: 83% of MA Beneficiaries Choose $0 Premium Plans for 2024
Seniors are mostly still interested in $0 premium Medicare Advantage plans, according to a new eHealth report. However, slightly fewer seniors are choosing these plans compared to previous years.