Here are seven Medicare Advantage updates Becker’s has reported since July 31:
- The CEOs of the six largest for-profit insurers have different perspectives on Medicare Advantage. Here is what six insurer CEOs had to say on second-quarter earnings calls about the state of Medicare Advantage.
- The health insurance industry is planning “a seven-figure lobbying blitz” in Washington D.C. to fight mounting headwinds and offer a more optimistic view of the benefits MA plans can provide to older adults.
- Medicare Advantage costs could rise in the second half of 2024, CVS Health CFO Tom Cowhey told investors. Mr. Cowhey said costs in inpatient care, dental and pharmacy all rose toward the end of the second quarter, and the company’s guidance for the rest of the year reflects that costs in the second half of the year could be higher than the first.
- In 2022, Medicare Advantage insurers denied 7.4% of prior authorization requests, according to data published by KFF. CVS Health had the highest rates of prior authorization denials in 2022 at 13%. Centene was most likely to overturn a prior authorization denial decision when appealed.
- Insurers made billions from diagnoses added to Medicare Advantage beneficiaries’ charts during home visits, The Wall Street Journal found in an investigation published Aug. 5. UnitedHealth Group said the Journal investigation “fundamentally misrepresents” its HouseCalls business.
- The Medicare Advantage sector needs to get better at understanding where it can deliver value to taxpayers, Humana CEO Jim Rechtin said.
“How do we actually collaborate with CMS to make sure that the regulatory environment allows that value to accrue back, or some of that value to accrue back? None of that should be harmful to the MA sector,” he said.
- Humana expects to lose a “few hundred thousand” Medicare Advantage members through market and plan exits in 2025, executives said.
