Strategic Shifts in Medicare Advantage: UnitedHealth's New Profitability Focus
Discover how UnitedHealth Group's strategic shifts in Medicare Advantage are reshaping profitability and compliance in the health insurance landscape.
CMS Mandates Reporting for Medicare Advantage Plans by 2027
Explore CMS's upcoming mandate for Medicare Advantage plans and its impact on insurance reporting and healthcare efficiency. Stay informed on the latest reforms.
Domestic-Terrorists, Foiled LA, NYE Bomb Plot Reinforces Why Date-Driven Risk Matters for Insurers
Federal prosecutors say they have charged four people with plotting coordinated bombing attacks across Southern California beginning on New Year’s Eve, an alleged scheme that underscores the volatility of holiday-period risk for insurers and risk managers.
Medicare Advantage Members Leave $5 Billion in Unused OTC Benefits Annually
Medicare Advantage members leave $5 billion in unused over-the-counter benefits yearly. Understand the impact and ways to maximize these essential healthcare allowances.
CMS Proposes Major 2027 Medicare Advantage, Part D Rule Revisions
CMS proposes extensive 2027 changes to Medicare Advantage and Part D, including Star Ratings overhaul and $14B spending increase. Insurers should assess impacts on quality bonuses and compliance.
Study Highlights Elevated Administrative and Financial Burdens in Medicare Advantage for Patients with Multiple Chronic Conditions
Analysis reveals higher administrative and financial burdens for Medicare Advantage enrollees with multiple chronic conditions, highlighting the impact of managed care on treatment complexity.
UnitedHealth Seeks Dismissal of Ballad Health Medicare Advantage Lawsuit
UnitedHealth Group moves to dismiss Ballad Health's Medicare Advantage lawsuit citing binding arbitration agreements and jurisdiction issues in federal court.
CMS Proposes Medicare Advantage Star Ratings Changes for 2027, Emphasizes Integrated Care for Duals
CMS's 2027 Proposed Rule for Medicare Advantage revises Star Ratings by focusing on clinical quality and member experience, delaying equity-focused rewards, and enhancing integrated care for dual-eligible populations.
Cleveland Clinic Joins AmeriHealth Caritas Florida Network in 2026
Starting 2026, Cleveland Clinic expands healthcare access through AmeriHealth Caritas Florida’s network, enhancing provider options for Marketplace and Medicare Advantage members in South Florida.
Maine Faces Surge in Medicare Enrollment Assistance Demand Amid Plan Disruptions
Rising Medicare Advantage plan terminations in Maine drive unprecedented demand for enrollment assistance, highlighting resource constraints amid complex federal and provider changes impacting seniors' health coverage.