Medicare Advantage

Peak Health is planning its largest expansion to date in the Medicare Advantage market, more than doubling its potential footprint in its home state and moving into Pennsylvania for the first time. “We’re looking to expand substantially. We will be…

Medicare Advantage enrollment in rural America has quadrupled since 2010, reaching 40% of eligible beneficiaries in 2023, but still far below the 53% penetration in metropolitan areas.  Rural beneficiaries now have an average of 27 MA plans to choose from,…

The coming year is expected to be an even more “intense and disruptive” period for Medicare Advantage, as rising utilization, pharmacy costs and shifting market dynamics put new pressure on plans, while also creating opportunities for provider-sponsored models. Becker’s connected…

Priority Health, the insurance arm of Grand Rapids, Mich.-based Corewell Health, is focused on long-term Medicare Advantage sustainability as the industry navigates rising costs and utilization. Becker’s connected with Interim President Nick Gates about how the insurer continues to integrate…

As major insurers pull back on their Medicare Advantage offerings, health system-owned plans told Becker’s they’re eyeing an opportunity to regain ground ahead of the annual enrollment season. “We’re hopeful that CMS and the current administration are really going to…

Major insurers are retrenching their Medicare Advantage strategies as federal cost‑containment measures and rising medical expenses squeeze profitability. Amid the growing financial pressures the industry has faced for nearly two years, the largest MA carriers are cutting supplemental benefits, exiting…

Alignment Healthcare posted its first quarterly profit and raised its full-year membership, revenue, adjusted profit and adjusted EBITDA outlooks in its second quarter earnings published July 30. “Our strong Q2 performance proves two things: one that there is a model…

St. Louis-based Mercy is targeting closer partnerships with fewer organizations, Gavin Helton, MD, president of primary care at the system, told Becker’s.  One of these partnerships is with Humana. Mercy and Humana opened their first collaborative 65Prime+ Clinics in Springfield…

HHS says it has launched a study into “misleading” Medicare Advantage marketing practices “and the harms they cause to individuals.” “In recent years, concerns about aggressive and deceptive marketing practices in Medicare Advantage have become more pressing,” the HHS OIG…

Humana is launching a collaboration with Epic’s MyChart, allowing members to see health plan details alongside the rest of their medical information.  The partnership is the first of its kind, Humana said in a July 15 news release.  “This integration…