CMS Launches MAHA ELEVATE Model to Advance Functional and Lifestyle Medicine in Medicare
CMS launches MAHA ELEVATE model to fund functional and lifestyle medicine initiatives for Medicare, promoting preventive care and value-based approaches.
Medicare Advantage Leads with Integrated Clinical Strategy and Member Engagement
Medicare Advantage plans are advancing outcomes by integrating clinical excellence, AI-driven engagement, health literacy, and community partnerships to support holistic member care.
Stellar Health's MSSP ACO Achieves $5M Medicare Savings with Tech-Enabled Model
Stellar Health's MSSP ACO surpasses Medicare average savings with $5M saved in 2024, leveraging tech-enabled micro-incentives to improve provider performance and patient outcomes in value-based care.
Growth in Special Needs Plans (SNPs) Drives Medicare Advantage Enrollment
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.
Community Paramedics Reduce Hospital Readmissions Under Medicare Penalties
Community paramedics and post-discharge monitoring reduce hospital readmissions and Medicare penalties, improving patient outcomes and cost efficiency in Minnesota hospitals.
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.