INSURASALES

Tag: Value-Based Care

Medicare Advantage Challenges and Opportunities for Skilled Nursing Providers

Trilogy Health Services CMO discusses Medicare Advantage's impact on skilled nursing, focusing on administrative challenges, appeals, and value-based care opportunities. Insights on I-SNP partnerships and payment simplification for providers.

AI-Driven Predictive Analytics Enhance Diabetes Care and Reduce Medicare Costs

Explore how AI-powered predictive analytics improve diabetes management and reduce Medicare costs through personalized patient adherence interventions.

TailorCare Expands Value-Based MSK Care for Humana Medicare Advantage in Dallas, Denver

TailorCare extends its value-based musculoskeletal care program to Humana Medicare Advantage members in Dallas and Denver, enhancing personalized care coordination and outcomes.

Delaware Analysis Shows GLP-1 Rebates Keep Drug Costs Stable Despite Increased Use

Delaware Department of Insurance analysis finds GLP-1 drug prices effectively stable after rebates, indicating limited impact on health insurance cost increases despite higher utilization.

CMS Proposes 6.4% Medicare Payment Cuts to Home Health Agencies for 2026

CMS proposes a 6.4% cut in 2026 Medicare payments to home health agencies, driven by PDGM budget neutrality adjustments and expanding Medicare Advantage enrollment. HHAs must assess financial impacts, advocate, and optimize operations.

Agilon Health Q2 2025 Earnings: Revenue Decline and Leadership Shift Amid Market Challenges

Agilon Health reports Q2 2025 results with $1.4B revenue, leadership changes, and suspends 2025 guidance amid Medicare Advantage market challenges and strategic operational shifts.

CMS Proposes 2.4% Medicare Payment Increase and New Two-Tier Physician Reimbursement Model for 2026

CMS proposes 2.4% Medicare payment increase for outpatient and surgery centers in 2026 with a new two-tier physician payment model to promote value-based care participation, amid concerns over long-term financial sustainability for providers.

Clover Health Launches Community Pharmacy Pilot in New Jersey

Clover Health partners with IPC Digital Health to launch a community pharmacy pilot in New Jersey, leveraging AI and local pharmacists to improve medication adherence and health outcomes for Medicare Advantage members.

Medicare Underpayment Intensifies U.S. Physician Shortage, Impacting Care Access

Medicare's underpayment to physicians is accelerating the U.S. doctor shortage and threatening healthcare access. Proposed payment reforms aim to realign Medicare reimbursement with practice costs and value-based care.

15 Years After the ACA: Transformations in U.S. Healthcare Marketing and Strategy

Explore how the Affordable Care Act reshaped U.S. healthcare marketing and strategy over 15 years, emphasizing consumer focus, digital innovation, and value-based care.