Medicare business news on MA, PDP and related topics

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“The CMS has been engaging in an ongoing effort to modernize the way it pays for primary care, and the current administration has shown no interest in getting in the way of that effort.”
-Rachel Burton, Senior Research Associate, Urban Institute


As of 2016, the five largest for-profit insurers — UnitedHealthcare, Anthem, Aetna, Cigna, and Humana — had 125 million members, representing 43% of the country’s total insured population. In 2016, Medicare and Medicaid accounted for 59% of combined U.S. revenue for the five insurers, more than doubling since 2010, from $92.5 billion to $213.1 billion. Collectively, the five insurers’ membership grew by 23 million (23%) from 2010 to 2016, with four of the five growing by at least 20%.

Excerpted From: The Commonwealth Fund

What's News
  BCBS opens “Medicare Centers” to deal with customer confusion on healthcare
WIVB, December 10, 2017

More billing codes, demonstrations help bridge physician payment gap
Healthcare Dive, December 8, 2017

AARP: Congress must prevent 'sudden cut' to Medicare in 2018
The Hill, December 7, 2017

Medicare surcharge notices are shocking retirees
Investment News, December 5, 2017

Hospitals and lobbying groups at odds over Medicare policy
Modern Healthcare, December 4, 2017

Why Medicare Advantage Is Marching Toward 70% Penetration and What It Means
Fierce Healthcare, December 4, 2017

Congress May Soon Help Prevent Medicare Enrollment Mistakes
Forbes, December 1, 2017

Cigna-HealthSpring, Lyft Make Medical Transportation Easier for Customers in MA Plans
BusinessWire, November 30, 2017

Updated Medicare Part D Opioid Drug Mapping Tool Unveiled
CMS, November 29, 2017
Why 50-year-olds should be eligible for Medicare
Chicago Tribune, December 11, 2017

Why Seniors Choose Medicare Advantage
AHIP, November 30, 2017
Medicare Video
MACRA Final Rule 2018: Navigating MIPS  

MACRA Final Rule 2018: Navigating MIPS

The MACRA Quality Payment Program Final Rule for 2018 is out! This webinar reviewed the changes made to MIPS that will be seen in 2018, and touch on some big changes to expect in 2019 and beyond. The second half of the webinar featured an open question and answer session.


Check out HealthshareTV, the home for health care videos  
healthsprocket lists

L.E.K. Consulting: MA County-Level Projection Model, 5 Takeaways

1. Medicare Advantage’s march forward will continue apace until its penetration rate hits 70%. rising from roughly 20 million, or 35% penetration
2. Medicare Advantage’s march forward will continue to 38 million, or 50% penetration, by the end of 2025.
3. Click to continue

 Source: L.E.K. Consulting

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