Tag: Medicare Advantage

CMS-Aims-To-Streamline-Prior-Authorization

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
Value-Based-Payment-Models-Can-Limit-Healthcare-Spending

Value-Based Payment Models Can Limit Healthcare Spending

Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
Congress-to-Help-Primary-Care

Time is Running Out for Congress to Help Primary Care

Time is running out for Congress to take action on pending legislation dealing with issues that would help primary care across the United States. Six physician groups representing 590,000 doctors across the country sent a joint letter again urging congressional leaders to vote – soon – for bills relating to Medicare reimbursements, prior authorizations, children’s […]
Medicare-Advantage-Bill-Response-To-Complaints

The Medicare Advantage Bill Was Crafted In Response To Complaints

The bill was crafted partly in response to rising complaints among seniors over aggressive marketing practices for Medicare Advantage plans. U.S. Sens. Maggie Hassan, D-N.H., and Dr. Roger Marshall, R-Kansas, have introduced the bipartisan Medicare & You Handbook Improvement Act, which is meant to ensure that when seniors assess their Medicare coverage options, they have the necessary […]
Is-Medicare-Advantage-Really-a-Disadvantage

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
Prior Authorization Reform in Medicare Advantage | Case Studies | AllZone Management Services Inc.

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]