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CMS proposed rule expands telehealth for Medicare Advantage plans, beefs up payment audits
A rule proposed late on Friday would enact several provisions of the Bipartisan Budget Act, including one that would allow MA plans to offer more telehealth benefits than traditional Medicare.
Medicaid enrollment slowed in 2018, but spending remained the same
With the economy back on its feet, Medicaid enrollment calmed this past year, but drug costs, behavioral health and long-term care services drive the bulk of spending, according to new analyses from the Kaiser Family Foundation.
Payer Roundup—North Carolina to begin Medicaid managed care; Anthem taps Google whiz for AI
Through a recently-approved §1115 waiver, North Carolina will begin transitioning its Medicaid population into managed care, with custom programs for certain populations. Plus, Anthem is bringing on Google’s former head of search products to work on AI.
Physicians frustrated by complexity and speed of alternative payment models, report says
New findings from the American Medical Association and the RAND Corporation say that physicians, especially those in small practices, feel APMs are becoming too complicated, and they’re not able to keep up with the whirlwind of regulatory changes surro…
Oscar heads into ‘strong’ individual market looking to lure members with consumer-centric onboarding
By functioning like a tech company—in its use of digital tools and operationally—the startup insurer hopes to provide a simpler, more personalized experience for consumers. That starts with the company’s interactions during open enrollment, Sara Wajnbe…
CMS expands flexibility for state ACA innovation waivers
Administrator Seema Verma says allowing states to “fundamentally restructure” their individual markets and shift consumers to short-term and association health plans won’t hurt people with pre-existing conditions, but some policy analysts aren’t so sur…
Medicaid managed care plans are making a foray into housing—but they can do more
In addition to medical care, UPMC and Kaiser Permanente are coordinating social services for their Medicaid managed care members experiencing or at risk of homelessness. But much more needs to be done.
To garner support for Medicaid, adopt ‘the Virginia way,’ says Gov. Ralph Northam
To expand Medicaid, the Virginia governor made an effort to ensure state legislators knew how their constituents would benefit. Evidence shows this is crucial.
Consumer-facing Medicare plan tools are inaccessible and inaccurate, experts say
Medicare Plan Finder frustrates many seniors, and there’s a lot of confusion over what star ratings mean, said multiple speakers at AHIP’s National Conference on Medicare.
‘Medicare-for-all’ compounds Medicare’s current problems, Verma says
Echoing her boss’s op-ed last week, Centers for Medicare & Medicaid Services Administrator Seema Verma devoted an unusually long time in one speech to why a popular progressive proposal would not work.
