Enrollment in provider-sponsored Medicare Advantage plans declined by nearly 60,000 members for 2025, according to a report from Chartis. The healthcare consulting firm published an analysis of CMS Medicare Advantage enrollment data March 25. Overall, Medicare Advantage plans gained 1.3…
The Latest
Specialized ICUs Reduce Readmissions
Sponsored
Kindred Hospitals, a national network of long-term acute care hospitals (LTACHs), provide specialized treatment and rehabilitation for medically complex patients. LTACHs like Kindred are equipped to provide the same level of treatment as short-term acute care hospitals (STACHs) can but…
The Tennessee Supreme Court has ruled in favor of BlueCross BlueShield of Tennessee in a case involving the termination of an employee who emailed state legislators opposing the company’s COVID-19 vaccine mandate. On March 26, the court reversed a lower…
Medicaid managed care insurers received at least $4.3 billion in duplicate payments for beneficiaries enrolled in multiple states between 2019 and 2021, The Wall Street Journal reported March 26. In many cases, Medicaid beneficiaries move to another state, but do…
Several states are considering regulating how insurers can use AI in prior authorization. In January, a California law took effect that prohibits payers from making coverage decisions based solely on artificial intelligence algorithms. The law requires any denial, delay or…
I. Introduction Payer-led care management serves as an important mechanism through which payers can exert influence on health outcomes, close care gaps, and enhance the performance metrics of health plans. It is progressively becoming more important in the rapidly evolving…
The average deductible for a Medicare Advantage plan more than doubled to $315 from 2024 to 2025, according to a March 26 survey from online broker eHealth. eHealth’s new analysis examined costs and plan selection trends for more than 250,000…
A federal judge in Minnesota has dismissed a proposed class-action lawsuit against Wells Fargo, which alleged the company mismanaged its employee health plan, resulting in inflated prescription drug costs for its employees. Originally filed in July 2024, the lawsuit accused…
Blue Cross Blue Shield plans accounted for around 30% of Medicare Advantage enrollment growth in 2025, according to an analysis from Chartis. The healthcare consulting firm published a report analyzing CMS Medicare Advantage enrollment data March 25. Overall, MA growth…
Moody’s has downgraded Health Care Service Corporation’s insurance financial strength rating to A3 from A2 following the company’s acquisition of Cigna’s Medicare business on March 19. Moody’s cited likely challenges with the integration of the MA business into the company’s…