November 9, 2023

The Healthcare Labyrinth Newsfeed Debuted This Week

Welcome to The Healthcare Labyrinth Newsfeed! Each weekday, I will review about two dozen healthcare websites for the most relevant information in the world of healthcare generally as well as managed care and health insurance specifically.

You can access the daily newsfeed in a few ways.

1 — Save this link in your favorites and visit each day

2 — If on LinkedIn, click on my daily post about the newsfeed and you will be redirected here.

3 — In the future, we will launch an email subscription (free) and we will email you each day on the newsfeed and other website activities.

Here is the rollout of the new Healthcare Labyrinth website:

November 6 — Newsfeed Debut

November 13 — Blog Debut

November 27 — Podcast Debut

I hope you enjoy the website and newsfeed.

Take care,


Medicare Advantage Plans and Home Health Providers Have Rocky Relationship

Home health providers are battling over rates as more and more seniors join Medicare Advantage over traditional Medicare fee-for-service (FFS). Home health providers complain that MA rates are demonstrably lower than FFS and that some plans own home health assets, which impacts their bottom lines. With a change in prior authorization policies in 2024, it will be harder for plans to deny home health services, though. (May require subscription)

#homehealth #medicare #medicare advantage

Link to Article

Advocates and Lawmakers Ask States To Pause Administrative Disenrollments in Medicaid

Advocates and some lawmakers are saying states should halt administrative Medicaid disenrollments until they can meet more rigorous safeguards so as to reduce the national 70% procedural disenrollment rate. So-called redeterminations came back as of April and over 10M have lost coverage, most of which for procedural reasons. The article notes that we are seeing the largest decline in Medicaid since 1996 to 1998. (May require subscription)

#medicaid #redeterminations #cms

Link to Article

GOP Presidential Debate Covers Healthcare Issues

Some time was spent on healthcare issues in last night’s debate. With regard to Medicare solvency, some candidates refused to say whether changes should be made, while others described some recommendations. These included raising the eligibility age for retirement/Medicare, pushing more Medicare Advantage penetration, and limiting benefits to wealthy Americans. Shame on the folks who dodged the question. It is a legitimate issue and needs debate (May require subscription)

#medicare #medicaresolvency

Link to Article

MedPAC Discusses Changes to MA

MedPAC has put many Medicare Advantage changes on the table the past several years, including surrounding rate reductions and Star reform. The commissioners are back with a laundry list of ideas to further reform MA. Commissioners discussed buyer’s remorse and a special enrollment period to return to FFS, but it is hard to argue there is a lot of that with the program growing so much. Despite what commissioners say, by and large seniors have become savvy consumers and have chosen well. Satisfaction shows this. Commissioners complain about prior authorization, but CMS has just put in a huge limitation here as well as a 90-day transition period with no authorization. Appeals and provider networks have oversight and have seen notable action recently. So many CMS rules have come out the past few years that MA plans’ ability to be innovative and save dollars will be constrained. While not all the ideas commissioners express are bad, taken as a whole it amounts to more regulation that could hurt the program.

#medicareadvantage #medicare #partc

Link to Article

Price Transparency Data Passes Smell Test

While the data is cumbersome and hard to use, researchers have found that hospital price transparency data does seem to comport with other commercial data available. Good news. Now on to simplification! (may require subscription)

#hospitals #pricetransparency #commercial

Link to Article

— Marc S. Ryan

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