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Medicare Open Enrollment Kicks Off: Be Aware Of Plan Changes For 2025

October 15, 2024 Morning Briefing

Enrollment in a 2025 Medicare plan opened for beneficiaries today. News outlets focus on an array of changes that could lead to “benefit disruption” which consumers should know about, in particular around Medicare Advantage choices and the prescription payment plan.

Study Finds Medicare Advantage Patients Experience Worse Home Care

March 4, 2024 Morning Briefing

Compared to people with traditional Medicare, patients on Medicare Advantage had worse outcomes and less home health care. Also: how Advantage costs are rising; virtual mental health company Talkspace aims at Medicare; and more.

Biden Administration Confirms 2025 Medicare Advantage Payments To Drop

April 2, 2024 Morning Briefing

Stat notes that the government wasn’t convinced by insurer and lobbyist efforts arguing that Medicare Advantage payouts wouldn’t cover the costs for people using health care. Also, experts warn Medicare coverage for Wegovy could hike monthly payments for many.

Report: UnitedHealth’s Tactics To Make Medicare Advantage Patients ‘Look As Sick As Possible On Paper’

October 16, 2024 Morning Briefing

The latest story in Stat’s investigation of UnitedHealth’s influence looks at the company’s strategy to enlist its doctors to pile moneymaking diagnoses onto patients covered by Medicare Advantage, using incentive tools like $10,000 bonuses and a doctor leaderboard. Other Medicare news is on low-cost drugs, value-based care, and more.

AARP’s Billion-Dollar Bounty

By Fred Schulte June 6, 2022 KFF Health News Original

With its latest venture into primary care clinics, is America’s leading organization for seniors selling its trusted seal of approval?

Hospitals Push For Medicare Advantage Boost To Cover 340B Drugs

April 23, 2024 Morning Briefing

Hospitals are arguing that since a Supreme Court ruling has reversed cuts made to 340B rates in 2018, Medicare Advantage reimbursement must be adjusted accordingly. Separately, a study shows drug representatives who meet with doctors have no effect on cancer patients’ survival rates.

Era of ‘Free’ Covid Vaccines, Test Kits, and Treatments Is Ending. Who Will Pay the Tab Now?

By Julie Appleby February 10, 2023 KFF Health News Original

Insurers, employers, and taxpayers will all be affected as drug manufacturers move these products to the commercial market.

KFF Health News' 'What the Health?': 2023 Is a Wrap

December 21, 2023 Podcast

2023 was another busy year in health care. As the covid-19 pandemic waned, policymakers looked anew at long-standing obstacles to obtaining and paying for care in the nation’s health care system. Meanwhile, abortion has continued to be an issue in much of the nation, as states respond to the Supreme Court’s 2022 decision overturning the constitutional right to the procedure. This week, Rachel Cohrs of Stat, Sandhya Raman of CQ Roll Call, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and wrap up the year in health. Also this week, Rovner interviews KFF Health News’ Jordan Rau about his joint KFF Health News-New York Times series “Dying Broke.”

Revised CMS Scores Yield Extra $200M In Bonus Payments For Centene

December 13, 2024 Morning Briefing

Centene told investors Tuesday that the company would get additional bonus payments after CMS updated its Medicare Advantage Star Ratings. More health industry news stories report on legal settlements, layoffs, private equity investments, and more.

CMS: 2025’s Medicare Advantage Prior Authorization Standards Are Set

April 5, 2024 Morning Briefing

Modern Healthcare says regulators will enhance Medicare Advantage “marketing, prior authorization, and network adequacy standards.” The publication also reports that higher fines are working to make more hospitals disclose pricing.

Once Off Limits, Medicare Cuts Now In The Mix As Senate Works On Tax Bill

June 6, 2025 Morning Briefing

Desperate to find savings in President Donald Trump’s budget bill, Senate Republicans are opening the door to changes to Medicare — which they previously indicated would not be a part of the legislation. Changes to target “waste and fraud” in private Medicare Advantage plans are high on the list. Meanwhile, news outlets also report cuts to Medicaid and the ACA are under consideration.

‘Big 3’ Medicare Advantage Insurer Algorithms Deny 1 in 4 Post-Acute Care Requests: Probe

October 17, 2024 Morning Briefing

A Senate investigation found the three largest Medicare Advantage insurers have been increasingly denying seniors claims since adopting AI and algorithms to help streamline the approval process, reaching a nearly 1 in 4 denial rate since 2022.

Now Included In First-Aid Guidelines: Overdoses, Seizures, And More

December 4, 2024 Morning Briefing

In the first update since 2010, the American Heart Association and the American Red Cross have included how to treat opioid overdoses and open chest wounds, among other things. Other industry news includes strikes, hospital closures, Medicare Advantage, and more.

Judge Rules CMS Miscalculated Medicare Star Rating for SCAN Health

June 5, 2024 Morning Briefing

SCAN Health Plan had sued CMS, saying regulators didn’t properly calculate the insurer’s Medicare Advantage rating. The decision could have industrywide implications, Modern Healthcare says.

KHN’s ‘What the Health?’: News You Might Have Missed

April 14, 2022 KFF Health News Original

Congress is in recess, so the slower-than-average news week gives us a chance to catch up on underreported topics, like Medicare’s coverage decision for the controversial Alzheimer’s disease drug Aduhelm and ominous new statistics on drug overdose deaths and sexually transmitted diseases. Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.

Survey Finds Nearly 80% Dissatisfied With Cost Of Health Care In US

December 9, 2024 Morning Briefing

In the lowest marks in over two decades, a Gallup poll finds that only 19% of Americans are satisfied with the costs of health care in 2024. Quality ratings suffer as well, with less than a majority of people giving “good” or “excellent.” And a separate survey looks at Medicare Advantage plans.

Medicare Plans’ ‘Free’ Dental, Vision, Hearing Benefits Come at a Cost

By Phil Galewitz October 27, 2021 KFF Health News Original

The ads for supplemental Medicare Advantage plans describe vision and dental benefits, even grocery discounts and food deliveries. But look at the fine print.

CMS To End Advance-Payment Program For Those Affected By Hack

June 18, 2024 Morning Briefing

The program, launched in March in the aftermath of the Change Healthcare cyberattack, sent advance payments to providers whose operations were disrupted. CMS also announced a do-over of 2024 quality scores for Medicare Advantage plans.

Under Trump, Privately Run Health Care Plans Favored Over ACA And Medicaid

November 7, 2024 Morning Briefing

In the aftermath of the election, health care companies that offer federally funded plans, like ACA and Medicaid, are likely to suffer, while private ones, like Medicare Advantage, will likely benefit from the Republican win. Also, more about what to expect from the Trump presidency.

Morning Briefing for Thursday, November 30, 2023

November 30, 2023 Morning Briefing

Medicare Advantage, a possible Cigna-Humana merger, covid wastewater tracking, Medicaid expansion, women’s health, and more are in the news.

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