Tag Archives: medicare

Navigating the Future of Medicare Advantage Plans

Recently, Medicare Advantage (MA) plans have surged in popularity, accounting for more than 50% of coverage for Medicare beneficiaries. Consequently, this rise has intensified competition among payors, leading to increasingly aggressive marketing strategies. To thrive in this competitive landscape, MA providers must differentiate their plans. Experience shows that targeting specific demographic segments is an effective strategy, and MA plans are… Read More »

Evaluating Quality and Cost Between Medicare Advantage & Traditional Medicare

With enrollment in the Medicare Advantage (MA) program continuing to rise and nearly 50% of all Medicare eligible beneficiaries participating in an MA product, now is the time to evaluate the program’s benefits and possible unintended consequences. Why? A recent study by Landon et al., published in the Journal of the American Medical Association, compared the two programs… Read More »

How Can We Overcome the Unintended Consequences of Medicare Advantage Expansion?

Since the formation of the Medicare Advantage (MA) program, there has been continuous growth in the number of Medicare beneficiaries that have chosen this model of care. The reasons are numerous. For instance, the pace of growth in the number of company offerings and members has picked up over recent years, and the current projection is that MA… Read More »

Physician Practices with Robust Capabilities Spend Less on Medicare Beneficiaries

As consolidation and integration of physician practices occur, especially within organizations that can wrap capabilities around ambulatory clinical care, we must examine the potential benefit to those we serve. This ideal is also the premise for a clinically integrated network where payment models are designed to allow for enhanced capabilities available to smaller groups of clinicians. These enhanced… Read More »

Why Using Social Determinant Metrics in The Hospital Readmission Penalty Calculation Matters?

Currently, there is an ongoing debate whether Medicare readmission penalty policy is equitable to all hospitals. The greatest argument and concern is the lack of social determinants of health (SDOH) factors in the calculation. Many contend including SDOH is essential to create greater equality amongst the comparisons. In contrast, others do not believe they are impactful or state… Read More »

Let’s Focus on the Problems Instead of a “Sound Bite Solution.”

As the election nears, the conversation concerning “Medicare for All” is being deeply debated. In a country that historically loathes government interventions into our lives, this is quite a significant shift. What is leading to many feeling single-payer is the way to go? If we step back and review many of the issues, we have in healthcare today;… Read More »

The Continued Financial Burden of Home Care

trusted partner

We can’t discuss the challenges in healthcare without considering the aging population who will be moving to home care settings more and more in the coming years. Shifting the focus to home care and the value it brings, it is necessary to remember that the patient and their families absorb a portion of these costs. And the financial… Read More »