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Inspector General’s Report Raises Red Flags Over Billions In Medicare Advantage Payments To Private Insurers

December 13, 2019 Morning Briefing

An Inspector General report suggests that private insurers are combing through patients’ files and adding on conditions like diabetes to make the patient looks sicker than they were to get more money from the government. A spokeswoman for America’s Health Insurance Plans said the report is based on a type of data with well-documented challenges, and noted that the watchdog didn’t review medical records for the analysis.

Medicare Advantage Paying For A New Air Conditioner? Plans Starting To Embrace Flexibility In Offered Benefits

October 7, 2019 Morning Briefing

The federal government has encouraged Medicare Advantage plans to offer perks that address the social and environmental factors associated with improved health.

New Medicare Advantage Plans Offer Many New Supplemental Options That Regular Medicare Doesn’t

September 26, 2019 Morning Briefing

About a third of people opt for Medicare Advantage plans, and during the upcoming enrollment period they will now see options for things that will help them prevent illness, like carpet shampooing. But Medicare Advantage can still restrict access to doctors and hospitals. In news on Medicaid, the CMS acting director Calder Lynch identifies ways to control spending.

KHN’s ‘What The Health?’: The Labor Pains Of ‘Medicare For All’

February 20, 2020 KFF Health News Original

Organized labor is divided over whether to support “Medicare for All.” Meanwhile, many of the Democratic presidential candidates seem unable to use the health issue to their advantage. Rebecca Adams of CQ Roll Call, Jennifer Haberkorn of the Los Angeles Times and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this and more. Also, for extra credit, the panelists offer their favorite health policy stories of the week they think you should read, too.

Pandemic Forced Insurers To Pay For In-Home Treatments. Will They Disappear?

By Julie Appleby June 23, 2020 KFF Health News Original

With stay-at-home orders in place, hospitals experimented with delivering many treatments to patients where they lived. They were a success. As society reopens, the return of old payment practices may prevent the adoption of this new, efficient model of care.

Medicare Advantage Plans Shift Their Financial Risk To Doctors

By Phil Galewitz October 8, 2018 KFF Health News Original

Some private Medicare Advantage plans are offering large physician-management companies more money upfront and control of their patients’ care, but the doctors are responsible for staying within the budget.

Research Roundup: Marketplace Enrollment, Medicare Advantage And Surprise Bills

September 27, 2019 Morning Briefing

Each week, KHN compiles a selection of recently released health policy studies and briefs.

How Obamacare, Medicare And ‘Medicare For All’ Muddy The Campaign Trail

By Shefali Luthra May 13, 2019 KFF Health News Original

A talking point used by House Speaker Nancy Pelosi refers to all three of these distinct concepts in a way that could magnify public misperceptions.

Trump Expected To Unveil Today Initiative To Expand Medicare Advantage Plans

October 3, 2019 Morning Briefing

The president reportedly will sign an executive order that the White House hopes will be a potent way to compare Republican views about enhancing health care with the “Medicare for All” proposals endorsed by some Democratic presidential candidates.

Time For Checkup On Coverage: Here’s A Tip Sheet To Go Over To Examine Priorities During Upcoming Medicare Enrollment Period

October 4, 2019 Morning Briefing

The annual enrollment allows people to revise prescription drug plans and to switch between Medicare and Medicare Advantage. Other Medicare news is on concerns about the declining growth rate of primary care doctors.

Feds Join Lawsuit Alleging Sutter Health Padded Revenue With False Patient Data

By Samantha Young December 14, 2018 KFF Health News Original

The whistleblower complaint says that Sutter, one of the largest health systems in the U.S., exaggerated how sick certain Medicare patients were in order to collect higher payments from the government-funded program.

Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors

By Phil Galewitz October 15, 2018 KFF Health News Original

The private health plans that are an alternative to government-run Medicare continue to grow despite the Affordable Care Act’s cuts of billions of dollars in funding.

If You’ve Lost Your Health Plan In The COVID Crisis, You’ve Got Options

By Julie Appleby June 12, 2020 KFF Health News Original

But some of those options, like special enrollment periods, are time-sensitive.

Trump Expected To Detail His Vision For Improving Medicare Advantage Programs Thursday

October 2, 2019 Morning Briefing

In a speech scheduled in Florida, the president will try to draw a contrast between his plans for Medicare and the expansions that Democrats are considering. The administration is also close to choosing Dr. Stephen Hahn to head the Food and Drug Administration, sources tell Stat. In other news, a proposal to add wellness programs to the health insurance marketplace is drawing criticism and some health industry groups are pushing to be included in a pilot program to promote telemedicine.

Understanding Loneliness In Older Adults — And Tailoring A Solution

By Judith Graham March 14, 2019 KFF Health News Original

New research shows that older adults want close relationships with the people they care about and meaningful social roles.

Seniors Steamed Over Cuts To SilverSneakers Fitness Program

By Judith Graham December 6, 2018 KFF Health News Original

UnitedHealthcare has put the skids on offering SilverSneakers, the nation’s fitness program for seniors, as part of its benefit packages. A look at why and some alternatives.

Feds Settle Huge Whistleblower Suit Over Medicare Advantage Fraud

By Fred Schulte October 1, 2018 KFF Health News Original

A DaVita subsidiary will pay $270 million over allegations that it cheated the federal government for years.

Pay Close Attention To Subtle Changes, Cost Savings During Open Enrollment Period For Medicare, Health Officials Warn

October 14, 2019 Morning Briefing

Patients can choose to save money and find ways to gain new benefits by re-examining offerings from Medicare and Medicare Advantage, which are tweaked every year. News on the enrollment season is on how higher-rated plans influence decisions, as well.

Polémica por decisión de cortar programa SilverSneakers para adultos mayores

By Judith Graham December 6, 2018 KFF Health News Original

La interrupción del programa de ejercicios es el resultado de una acción de UnitedHealthcare, la compañía de seguros de salud más grande de la nación.

As Sanders Officially Revives Medicare-For-All, Plan B For Democrats Gains Traction

By Shefali Luthra April 11, 2019 KFF Health News Original

“Medicare for America” seeks to avoid some of the predictable obstacles of a full-blown expansion of Medicare. Can it survive the politics of health reform?

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