Medicare Advantage: ration care for millions

KFF: Use of Prior Authorization in Medicare Advantage Increased 26.6% and Exceeded 46 Million Requests in 2022, Humana and Anthem Top the List So it goes n8 DON'T PARTICIPATE IN THE MA VALUE SCAM https://lnkd.in/gEGFezSq #healthsystems #hospitals #medicareadvantage #valuebasedcare #valuebasednonsense #medicare

Significant changes are coming to Medicare Advantage (MA) Star Ratings — are you ready? Starting January 1, 2025, CMS will introduce new measures affecting the 2027 Star Ratings. This means MA plans and providers need to act now. Identifying which beneficiaries are impacted and planning how to meet their care needs is crucial, and the clock is ticking. Learn more here: https://lnkd.in/ekx6RmTh #FTIHealthcare #MedicareAdvantage #StarRatings #CMS2025 #MAplans #Healthcare #Healthcareproviders #Quality #CMSchanges #MedicareUpdates #StarRatings2027 #HEI #HealthEquity #HealthEquityIndex Reach out to: Mark Van Ert | Krunal Patel

#ICYMI: On October 10-11, the Medicare Payment Advisory Commission (MedPAC) held a meeting discussing #Medicare beneficiaries in nursing homes, findings from their annual beneficiary and provider focus groups, supplemental benefits in #MedicareAdvantage, and more. In the latest #ADVIAnalysis*, our ADVI Health experts break down the meeting and its key takeaways: https://lnkd.in/gRHvA6Wn *This is a delayed release. ADVI Analysis content is distributed in real-time for retainer clients.

We know the landscape of SNPs is constantly shifting. That's why we've created a convenient virtual newsletter, so all your updates can come in one easy bundle. Whether it be changes to MMPs or updates to Medicare plans, our SNP Alliance Newsletter will have you covered. Stay informed. Sign up today: https://bit.ly/4atLDw2 #SpecialNeedsPlans #Healthcare

Not all Medicare Advantage plans allow you to visit your preferred doctors and hospitals. 🏥 Provider networks are key! If you want to avoid unexpected costs, ensure that your favorite doctors are in your plan’s network. It can make all the difference in your care! 🩺 To view our Medicare disclaimers, visit the link in bio. #ProviderNetworks #MedicareAdvantage #DoctorAccess #SeniorHealthCare #Turning65Advisor #HealthCoverage #PlanSelection

New Rules always mean new loop holes... Check out this article by Ronald Hirsch, MD, FACP, CHCQM, CHRI, ACPA-C regarding Medicare Advantage Plans. It would seem CMS is trying to reduce the disparities between Traditional Medicare and Medicare Advantage, but still has a long way to go. One-way Hospitals can protect their Revenue in these changing times is by focusing on Readmission Reduction. Most MA Plans can avoid paying for these. How can we help you today? Link to article in comments #Medicare #Healthcare #CaseManagement #MEDOVENTSOLUTIONS

As you approach 65, it's important to get ready for Medicare. Make sure to enroll in Parts A and B and consider additional coverage options like Medigap or Medicare Advantage. #Medicare #Healthcare #SeniorCare 🏥

Struggling with complex hospice billing? Our latest blog covers critical trends, challenges, and tips to help your agency stay ahead. Topics covered: - Medicare scrutiny - Managing referrals - Multiple payers - Eligibility checks Stay informed and ensure timely reimbursements. Read now! https://bit.ly/3AVnMIv #HospiceBilling #HealthcareFinance #Medicare #HospiceBillingTips

Did you know? Medicare Advantage plans require you to use a network of doctors and hospitals. Make sure your preferred providers are in-network. #MedicareAdvantage #HealthInsurance

We need one unified appeal process regardless of Medicare Advantage or commercial. Here's why: Take MCOs, for example: The prior authorization denial rate for Medicare Advantage is roughly 13%, and the appeal rate for these denials is only 11%. They also overturn high rates of appeals, indicating that if it was easy to appeal, denials would get overturned. Provider groups are bearing the brunt of this. Hence, we see hospitals dropping these plans left and right. Our goal at Crosby Health is to make it easier for providers and payors to adjudicate denials and provide patients with care. #medicareadvantage #medicare #healthcare