Medicare Advantage in the headlines: 6 recent updates

Newly released court documents show CMS dropped a proposal to require Medicare Advantage plans to return overpayments a decade ago, and J.D. Power published its annual ranking of the top MA plans. 

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Here are six MA updates Becker’s has reported since Aug. 16: 

  1. CMS dropped a proposed rule in 2014 that would have required Medicare Advantage plans to return overpayments found during chart reviews amid industry opposition, according to a report from KFF. 

  2. Around 1 in 5 Medicare Advantage beneficiaries switch to traditional Medicare when their plans shut down, a study published in JAMA Network Open found. 

  3. Clover Health CFO Peter Kuipers told Becker’s headwinds have “very little impact” on the Medicare Advantage plan. Founded in 2014, the company reported its first-ever profitable quarter in July. 
  4. MMM Healthcare, a Puerto Rico subsidiary of Elevance Health, received $59 million in net Medicare Advantage overpayments in 2017, according to an audit from HHS’ Office of Inspector General. Elevance did not purchase MMM until 2021. 
  5. UPMC has the highest-ranked Medicare Advantage plan for customer satisfaction in 2024, according to J.D. Power’s latest annual Medicare Advantage Study. Centene, Humana and UnitedHealthcare had some of the lowest-rated plans for customer satisfaction in their markets in 2024. 
  6. Health systems are grappling with various challenges in Medicare Advantage, such as excessive prior authorization denial rates and slow payments from insurers, but some organizations have positioned themselves for success. Here is one system’s secret to success. 

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

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Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

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