Medicaid Members To See Continued Coverage Through Mid-2025
Individuals who currently participate in Medicaid waiver programs are getting an additional year of benefits. CMS made this decision in an effort to boost retention for eligible Medicaid recipients. As…
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Essential Metrics for Your Health Plan’s Member Satisfaction
Member satisfaction has always been a strong barometer for health plan success. When looking at commercial payers, the most recent J.D. Power U.S. Commercial Member Health Plan Study found that…
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New Legislation Aims to Prevent Falls and Decrease Opioid Usage in Older Adults
Among those 65 and older, the Centers for Disease Control reports falls are the leading cause of injury deaths and responsible for nearly 3 million emergency department visits each year.…
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The Two-Midnight Rule: Additional Changes Expected for Medicare Advantage Members
This year is bringing even more changes for Medicare Advantage (MA) plans. One of the predominant adjustments is that MA plans will now follow the two-midnight rule. This means members’…
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The Medicare Advantage Playbook for 2025: New Rules, New Opportunities
In early April, the Centers for Medicare and Medicaid Services (CMS) finalized the 2025 Medicare Advantage Rule. This legislation also included changes to Medicare Part D, which covers prescription medications.…
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Medicare Advantage Spending Surge: What the 2023 Data Reveals & What Your Health Plan Needs to Know
A review of last year’s data shows a spike in service utilization for members with Medicare Advantage (MA) plans in 2023. This information came from an AHIP survey, which found…
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