Advertisement

Medicare Advantage

When San Diego-based Scripps Health walked away from nearly all of its commercial Medicare Advantage contracts Jan. 1, 2024, the move drew widespread attention across the industry. Medicare Advantage enrollment was still climbing nationally and many health systems were doubling…

A handful of insurers are boasting Medicare Advantage membership gains following the annual enrollment period. Annual enrollment ran from Oct. 15 to Dec. 7, setting the stage for 2026 numbers. However, despite membership growth among some carriers, the Medicare Advantage…

Alliance of Community Health Plans President and CEO Ceci Connolly sees momentum around risk adjustment reform picking up. “We see this administration taking very seriously the concerns over wide gaps in risk adjustment payments — gaps that are far outside…

Advertisement

Molina Healthcare will exit the Medicare Advantage Part D business in 2027, the company announced alongside its fourth quarter and full year 2025 earnings report published Feb. 5. The MAPD product represents approximately $1 billion in annual premiums. Molina said…

CMS is planning to continue its Medicare Advantage audits and overpayment recoveries, according to a Jan. 27 memo. While federal estimates point to $17 billion in overpayments each year, the last major risk-adjustment data-validation recovery took place in payment year…

Clever Care Health Plan ushered in almost 15,000 new Medicare Advantage members — membership growth of nearly 50% — during the 2026 Medicare annual enrollment period, according to a Feb. 3 news release from the company. Clever Care offers what…

Advertisement