Scan CEO Right On MA and FFS
Scan CEO Sachin Jain, MD is one of the brightest minds in healthcare. He has the right outlook on Medicare Advantage (MA) – it does a lot that is good but also needs reform. In addition, he rightfully is asking why the traditional fee-for-service (FFS) program does not face reasonable scrutiny for its over-utilization.
#scan #medicare #medicareadvantage
https://www.fiercehealthcare.com/payers/ahip-2024-cutting-through-nostalgia-traditional-medicare
More On CMS’ Recalculation Of MA Stars
Additional information is coming out on the recalculation of Medicare Advantage (MA) Stars for 2024. CMS is expected to have to pay out at least $1.3 billion in additional bonus payments in 2025 for 2024 Stars.
(Article may require a subscription.)
#medicareadvantage #stars #cms
https://www.modernhealthcare.com/medicare/2024-medicare-advantage-star-ratings-elevance-aetna-scan
House GOP Grills Medicare Innovation Director
House Energy and Commerce Committee Republicans grilled the Centers for Medicare and Medicaid Services (CMS) innovation center director on the financial track record of Medicare reform pilots.
(Article may require a subscription.)
#cms #medicare #healthcarereform
https://insidehealthpolicy.com/daily-news/house-gop-grills-cmmi-director-model-successes-eyes-cuts
CalOptima Increases Medi-Cal Rates Dramatically
Medi-Cal plan CalOptima Health will increase provider rates by some $526 million.
#providers #rates #medicaid #healthplans
https://www.beckerspayer.com/payer/california-payer-boosts-medicaid-rates-by-526m.html
BCBS Units Report Medicare Advantage Headwinds
Blue Cross Blue Shield plans are reporting the same headwinds that many national health plans have seen. The poor financial trends stem from poor rate hikes (due to a new risk adjustment model), poor Star results, new regulatory burdens (especially prior authorization changes), and a return of utilization.
#medicareadvantage
https://www.beckerspayer.com/payer/medicare-advantage-headwinds-hit-bcbs.html
— Marc S. Ryan
