Court upholds CMS decision on Humana Medicare Advantage star ratings amid rising class-action insurance lawsuits involving provider network inaccuracies and insurer duties.
Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.
Examining Aetna's new inpatient payment policy for Medicare Advantage plans, its conflicts with Medicare's Two-Midnight Rule, and implications for hospital reimbursement and compliance.
Banner Health's insurance plan integrates health system data and AI technology to improve care coordination, compliance, and member experience in Medicare and Medicaid markets.
Medicare Advantage plans are advancing outcomes by integrating clinical excellence, AI-driven engagement, health literacy, and community partnerships to support holistic member care.
Special Needs Plans (SNPs) are driving significant growth in Medicare Advantage enrollment in 2025, with chronic condition and dual-eligible SNPs leading gains. Institutional SNPs decline amid evolving care models.
FirstMedicare Direct will close operations by end of 2025, affecting 6,000 Medicare Advantage members. This exit highlights challenges in the Medicare Advantage insurance market.
Medicare Advantage market pivots from growth-at-any-cost to profitability-first amid CMS regulatory tightening and rising medical costs. Key strategic shifts include operational efficiency, agility in member services, and investment in clinical programs to improve outcomes and reduce total care costs.
Samaritan Health Plans exits Medicare Advantage in Lincoln County, Oregon, leaving Devoted Health as sole 2026 provider. Insights on market sustainability, special enrollment, and resources for seniors.
Medicare Part B premiums are set to rise significantly in 2026 amid medical inflation, while Part D prescription drug costs slightly decline nationally. Enrollment opens October 15 for plan changes including Medicare Advantage and Medigap options.
