The way to determine the quality of a Medicare Advantage health plan is simple: look at the five-star rating on the Medicare website. However, the Medicare Advantage Star Rating methodology that produces that star indicator is much more complex. A Medicare Advantage plan is a private payer health plan which the federal government funds and…
The number of Medicare Advantage plans investing in supplemental benefits to address social determinants of health tripled in a single year, but additional guidance and standards from the Biden administration are needed, a new report said. The report, released Thursday by the Better Medicare Alliance, comes as the Biden administration has made it a priority…
As Medicare Advantage continues to serve a proportionally higher-risk and more diverse enrollment population, a new report highlights innovative approaches to addressing social determinants of health (SDOH) for Medicare Advantage beneficiaries, while acknowledging barriers that remain. Social determinants of health are non-medical factors that account for up to 55% of an individual’s health outcomes, according…
In recent years, Medicare Advantage (MA) plans have increasingly turned their attention to addressing members’ social determinants of health (SDoH), with the home playing a crucial role. That’s according to a new report from NORC at the University of Chicago. NORC conducted the report on behalf of Better Medicare Alliance’s (BMA) Center for Innovation in…
Humana’s Bold Goal strategy led to a 6.8 percent decrease in the number of unhealthy days for San Antonio members. A previous version listed 8.6 percent as the figure. Humana has partnered with a technology platform and a group of community-based organizations to address social determinants of health for Medicare Advantage members in San Antonio, Texas. Alamo…
The healthcare industry in the U.S. has spent a whole generation talking about moving from a fee-for-service to a value-based model, focusing more on improved patient outcomes and early interventions rather than disease treatment. This shift has occurred gradually, sometimes purposefully, and sometimes in fits and starts, but overall, it has been slower than expected….
Two influential advisory groups sent recommendations to Congress calling for a revamp of how health plans are paid in the lucrative Medicare Advantage program, culling how many models CMS tests and curbing high-cost drug approvals. By many measures, the MA program has been thriving. Enrollment and participation has continued to grow, and in 2021, MA…
Hospice providers are increasingly turning to data analytics systems to gain an edge against competitors when engaging prospective referral partners, anticipating impacts in value-based care. Data are key to demonstrating the value of hospice to potential referral partners as evolving value-based payment models take effect. The value-based insurance design demonstration project, commonly called the Medicare…
Having helped several Medicare Advantage plans achieve significant quality performance improvements (up to 1.1 stars improvement YoY in 2020 alone), Stellar Health (Stellar) is sharing its perspective on what it takes to sustain and improve Star Ratings for health plans and why there is a need for action despite even a few years of success….
A robust hospice mergers and acquisitions market is showing no signs of slumping as interest among strategic buyers and private equity investors ramps up. A provider’s performance within evolving value-based payment models may become a factor that potential buyers consider when eyeing a hospice acquisition, particularly as it pertains to their quality and outcomes data….