Category: Medicare Advantage

Medicare Advantage Insurers Often Use Rewards and Incentives to Encourage Enrollees to Complete Health Risk Assessments (HRAs)

This analysis examines the share of Medicare Advantage enrollees in contracts (which usually include multiple plans) that offered rewards or incentives for completing health risk assessments (HRAs) in 2023, as well as differences across Medicare Advant…

When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too

Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.

KFF Health News’ ‘What the Health?’: Can Congress Reconcile Trump’s Wishes With Medicaid’s Needs?

When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss this story and more. Also, Rovner interviews KFF Health News’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.

Will the Trump Administration Fast Track the Privatization of Medicare?

The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It’s not yet clear whether the admini…

A Backlash Against Health Insurers, Redux

In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns –…

UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments

A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.

In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M

A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.

TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead

Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.

KFF Health News’ ‘What the Health?’: Trump’s Nontraditional Health Picks

Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state’s abortion ban.

KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records

Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.