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Showing 201-220 of 1,618 results for "medicare advantage"

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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.

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A photo shows an IUD resting on a surface decorated with a grid pattern.

For Young People on Medicare, a Hysterectomy Sometimes Is More Affordable Than Birth Control

By Gina Jiménez March 7, 2023 KFF Health News Original

While Medicare was designed as health insurance for those 65 and older, it also covers people with disabilities who are young enough to still get pregnant. Yet they often struggle to get their birth control covered and end up with large medical bills — or instead opt for hysterectomies or tubal ligations, which Medicare sometimes will cover.

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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.

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Medicare Advantage Patients Complain To CMS About Lean Provider Networks

June 3, 2024 Morning Briefing

CMS sought comments on ways that it can improve Medicare Advantage. The majority of feedback came from providers, but beneficiaries also weighed in with horror stories about deficient networks.

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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.

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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.

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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.

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‘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.

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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.

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What the Health? From KFF Health News: Newly Minted Doctors Are Avoiding Abortion Ban States

May 9, 2024 Podcast

For the second year in a row, medical school graduates across specialties are shying away from applying for residency training in states with abortion bans or significant restrictions, according to a new study. Meanwhile, Medicare’s trustees report that the program will be able to pay its bills longer than expected — which could discourage Congress from acting to address the program’s long-term financial woes. Lauren Weber of The Washington Post, Joanne Kenen of the Johns Hopkins University schools of nursing and public health and Politico Magazine, and Anna Edney of Bloomberg News join KFF Health News’ Julie Rovner to discuss these stories and more.

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This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True

By Bram Sable-Smith November 1, 2022 KFF Health News Original

Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. They’ve created a shared internal database to monitor questionable business practices, and, in the future, they hope to provide a public-facing resource for consumers. In the meantime, consumers should shop wisely as open enrollment season begins.

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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.

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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.

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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.

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UnitedHealth Doctors Got Diagnoses Checklists To Boost Medicare Payouts

January 2, 2025 Morning Briefing

The Wall Street Journal reports how UnitedHealth provided lists of potential, often obscure diagnoses to its doctors and forced them to weigh in on them for each Medicare Advantage patient, in order to capitalize on the government system that pays private insurers based on how sick doctors say a patient is.

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Three photos are shown side-by-side. From left to right are a photo of a covid vaccine; a photo of a covid rapid test; a photo of Paxlovid.

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.

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What the Health? From KFF Health News: New Year, Same Health Fight

January 8, 2026 Podcast

Congress returned from its break facing a familiar question: whether to extend the expanded subsidies for Affordable Care Act health plans that expired at the end of 2025. Meanwhile, HHS Secretary Robert F. Kennedy Jr. broke a promise to Bill Cassidy, the chairman of Senate health committee, by overhauling the federal government’s childhood vaccine schedule to reduce the number of diseases for which vaccines will be recommended. Sarah Karlin-Smith of Pink Sheet, Alice Miranda Ollstein of Politico, and Lauren Weber of The Washington Post join KFF Health News’ Julie Rovner to discuss those stories and more.

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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.

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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.

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Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans

By Susan Jaffe March 3, 2022 KFF Health News Original

Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.

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