Humana is challenging a rule from CMS that could leave insurers on the hook for billions in repayments, and new HHS research reveals most growth in the program is fueled by people switching from traditional Medicare.
Here are nine Medicare Advantage updates Becker's has reported since Aug. 25.
- Medicare Advantage enrollment is growing faster in rural and micropolitan areas than in metropolitan areas, according to an analysis from KFF.
- Most growth in Medicare Advantage enrollment since 2006 was driven by people switching from fee-for-service Medicare to the program, a study by HHS researchers published in the September issue of Health Affairs found.
- Medicare Advantage plans generally spend less per enrollee than traditional Medicare plans, but these differences vary widely by condition, a study published in the September issue of Health Affairs found. Chronic kidney disease had the largest difference in spending between MA and traditional Medicare beneficiaries.
- Medicare Advantage beneficiaries were less likely to receive ongoing at-home care than their counterparts in traditional Medicare but more likely to receive one-time visits, a study published in the September issue of Health Affairs found.
- Medicare Advantage is working for many, but it falls short for the sickest patients, according to Steven Gordon, MD, CEO of St. Charles Health System in Bend, Ore.
- Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans. The insurer filed the lawsuit in the U.S District Court in the Northern District of Texas, asking the judge to require CMS to vacate the final rule, which would allow CMS to clawback some payments made to MA plans.
- Wellcare, Centene's Medicare Advantage business, is partnering with the American Legion on Medicare Advantage plans designed to complement benefits veterans receive through the VA.
- Many Medicare Advantage beneficiaries disenroll from their plans within five years of enrolling, a study published in JAMA Health Forum found.
- U.S. Representative Ritchie Torres will introduce a "Right to Medicare" bill, requiring employers offering retirees healthcare benefits to allow them to opt-in to MA and also provide a traditional Medicare option. Mr. Torres, who represents parts of New York City, said the legislation is in response to the city's plan to shift 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan, which has been ruled against by a New York State Supreme Court judge.