MA Star Cut Points Rise
Good Healthcare Dive article on the release of Plan Preview 2 information for Medicare Advantage Stars and the new cut points. As the article discusses, assessing what will happen to overall Star ratings is hard to do. Tougher cut points can or cannot be a sign that things will go up overall.
My companion blog tends to think that some of the increases tie to true initiatives on performance improvement and others to MA plan exits. I think if things do go up overall, it will be modest. That blog is here: https://www.healthcarelabyrinth.com/two-star-blogs-in-one-what-will-cms-do-next-on-stars-and-despite-cut-point-moves-widespread-overall-ratings-hikes-unlikely/
#medicareadvantage #partd #stars #quality
https://www.healthcaredive.com/news/medicare-advantage-stars-cutpoints-2027-cms/829963
Federal Exchange Enrollees To Receive Rebate
The White House announced that it will issue $500 refunds to close to a million people enrolled in the federal Exchanges. The administration says the rebates are tied to overcharges collected in the Biden administration through user fees intended to fund the operation of the federal insurance exchange. Checks will be mailed in October, shortly before the midterms.
Additional articles: https://www.fiercehealthcare.com/regulatory/white-house-plans-500-refunds-nearly-1m-aca-enrollees and https://www.beckerspayer.com/payer/aca/trump-pledges-500-checks-to-1-million-people-for-aca-overcharges/ and https://thehill.com/policy/healthcare/6082253-trump-pledges-healthcare-rebate-checks/
#exchanges #healthcare #coverage
https://www.modernhealthcare.com/politics-regulation/mh-trump-500-refunds-aca-plans-obamacare
Unions, Employer, Advocates Want NSA Arbitration Reform
A coalition of nearly 70 unions, employers, and advocates want Congress to overhaul the No Surprises Act. The effort is led by advocacy group Families USA. The group rightfully notes that a handful of providers are flooding the program, leading to rises in premiums and other costs.
#nsa #nosurprisesact #providers #healthplans
https://www.modernhealthcare.com/insurance/mh-congress-no-surprises-act-insurers-employers
Healthcare Programs Will Need Fixes Late In Year
Healthcare program funding was resolved through the midterm elections but will need attention in a lame duck session in December. Lawmakers then will need to debate must-pass extensions and what else gets consideration.
#healthcare #congress
https://www.modernhealthcare.com/politics-regulation/mh-congress-healthcare-legislation-funding-bill
UnitedHealthcare And Others To Retrench Again In MA
UnitedHealthcare told investors it expects to be very competitive in Medicare Advantage (MA) in 2027, but it will include further exits and cutbacks in some areas while growing in more profitable ones.
UnitedHealthcare expects to end 2026 with up to 1.1 million fewer MA members than it had last year. UnitedHealthcare is considering leaving 34 counties in 12 states, impacting 1.2% of counties and about 20,000 people. UnitedHealthcare also plans to trim supplemental benefits.
Humana expects its exits will impact roughly 600,000 seniors — about 8% of its 7.2 million members in MA. CVS’ Aetna, Elevance and Centene also told investors it will be focused on margin recovery.
In other news, a study in the American Journal of Managed Care says switching between MA plans has become more popular in recent years, especially for dual eligibles. From 2016 to 2022, fully dually eligible, partially dually eligible and non-dually eligible beneficiaries who voluntarily switched between MA plans increased from 12.49% to 22.49%, 17.36% to 30.11% and 9.92% to 13.39%, respectively.
Additional article: https://www.beckerspayer.com/research-analysis/plan-switches-for-dually-eligible-ma-members-increasingly-common/
#medicareadvantage #enrollment #margins
Only Half Of Hospitals Comply With Transparency
While the rate is at a record high, just half of U.S. hospitals are in full compliance with federal price transparency rules. This is a finding of the nonprofit group Patient Rights Advocate (PRA).
#pricetransparency #hospitals
https://thehill.com/policy/healthcare/6081969-pra-report-hospital-pricing-rules
— Marc S. Ryan
