CMS's Medicare Advantage proposal reintroduces the reward factor, affecting insurer payments by $13B, and phases out the inpatient-only list, impacting outpatient care and rural health strategies.
New Medicare Advantage regulations offer some relief for insurers with falling quality star ratings, but top ratings remain challenging to achieve.
With Medicare Advantage open enrollment closing soon, learn crucial factors in choosing 2026 plans including provider access, benefits, costs, and Medicare star ratings to optimize coverage decisions.
Learn how to maximize your Medicare plan's vision benefits, including annual eye exams, vision allowances, and affordable stand-alone coverage options like VSP.
The unresolved contract dispute between UNC Health and Cigna risks out-of-network status for thousands of patients, reflecting broader insurer-provider negotiation challenges in North Carolina's healthcare market.
Rising cost pressures and demographic shifts fuel intensified disputes between payers and providers over Medicare Advantage contracts, impacting reimbursement and network participation.
Starting in 2026, MultiCare will no longer accept certain Medicare Advantage PPO plans, impacting access for some seniors. The shift focuses on HMO plans for better care coordination during Medicare open enrollment.
Geisinger Health Plan earns 2026 Best Insurance Company for Medicare Advantage in Pennsylvania, recognized for high-quality coverage and member services based on CMS quality measures.
CMS proposes to revamp Medicare Advantage Star Ratings, affecting insurer compliance and operations. Legal appeals and health system updates also impact the US market.
KFF research reveals widespread use of chart reviews in Medicare Advantage, increasing diagnoses and boosting CMS payments with AI-driven risk adjustment implications.
