Susan Dentzer of America's Physician Groups emphasizes accountable care relationships for Medicare beneficiaries to improve coordination, reduce hospitalizations, and support smaller practices.

Humana's legal loss against CMS over Medicare Advantage star ratings underscores structural regulatory risks reshaping insurer margins and strategies in the U.S. Medicare Advantage market.

Humana's lawsuit challenging its Medicare Advantage star ratings was dismissed due to incomplete administrative appeals. The insurer faces a major downgrade impacting 2026 earnings and plans further legal action.

Elevance Health lowers 2024 earnings guidance due to rising medical utilization, Medicaid eligibility checks resuming, and regulatory challenges impacting Medicaid and ACA programs.

CMS initiates survey collecting hospital outpatient drug acquisition costs to align Medicare payments with actual costs under the 2026 OPPS update, following a federal Executive Order to reduce prescription drug expenses.

Dr. Mehmet Oz discussed the role of healthy eating in sustaining Medicare during the program's 60th anniversary, highlighting the intersection of preventive health and insurance policy.

Understand how Original Medicare and Medicare Advantage plans cover individuals living in two states, including network restrictions, pharmacy access, and telehealth benefits.

Middletown faces scrutiny over unclear public spending and infrastructure planning, while Rhode Island Medicare Advantage plans drop key hospitals from network, impacting patient costs and care continuity.

Study reveals significant growth in payer-operated physician practices in Medicare primary care from 2016-2023, led by Optum with market trends linked to Medicare Advantage penetration and regional factors.

Medicare Advantage plans serving 30 million Americans may face cuts or changes due to rising medical utilization and costs. This impacts benefits, networks, and out-of-pocket costs, making the Medicare Annual Election Period critical for plan comparisons.