Medicare
The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.
Editor’s Picks
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Telemedicine Visits For Medicare FFS Beneficiaries Associated With Less Low-Value Testing
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Home Health Use Declined Among Medicare FFS Beneficiaries But Increased Among Medicare Advantage Members Between 2010 & 2020
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UnitedHealthcare Ends Home Health Prior Authorization For Medicare Advantage & D-SNPs In 36 States & DC
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Less Than 5% Difference In Prevalence Of Four Of Five Chronic Conditions Between Medicare Advantage & Fee-For-Service Populations, But Diabetes Is 27% Higher
Latest Resources
- Humana & Longevity Health Extend Medicare I-SNP Partnership Through 2030
- The Medicaid Question
- For Medicare Beneficiaries With Dementia, ACO Participation Had No Impact On End-Of-Life Care Processes, Outcomes & Health Spending
- Oregon Releases PACE RFP For Jackson & Josephine Counties
- Payer & Provider Organization Adoption Of Collaborative Care Model For Integrated Mental Health & Medical Care On The Rise Since 2018
- Louisiana Dual Eligible System: An OPEN MINDS State Profile
- Washington Dual Eligible System: An OPEN MINDS State Profile
- Medicare Accountable Care Organizations Generated From $4.1 Billion To $8.1 Billion In Savings Between 2012 & 2019
- Texas District Court Vacates Federal Minimum Staffing Requirements For Nursing Homes
- Nursing Home Staffing 22% Below Levels Expected By Resident Case Mix Acuity During 2024
- 2025 Medicare Advantage Deductibles Average $315, Up From $132 In 2024
- Arizona Medicaid Contract For Elderly/Disabled Members Changed After Protest
- Nebraska Dual Eligible System: An OPEN MINDS State Profile
- North Carolina Dual Eligible System: An OPEN MINDS State Profile
- Medicare Cost-Sharing Parity For Mental Health Treatment Linked To An Increase In Outpatient Mental Health Visits & Out-Of-Pocket Costs
After Medicare eased telehealth restrictions during the COVID-19 public health emergency, telehealth visits among fee-for-service (FFS) beneficiaries rose during 2020, but then stabilized in 2021 and beyond. The increased volume of telehealth visits was not associated with an increase in the volume of outpatient evaluation and management (E&M) visits. Telehealth-initiated episodes of care were associated with lower use of lab tests and imaging compared to in-person visits. Telehealth visits were associated with lower 30-day Medicare… Read
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Latest Industry Bulletins
- Humana & Longevity Health Extend Medicare I-SNP Partnership Through 2030
- CMS Suspends Eight MIPS Improvement Activities For 2025
- InHome Connect’s Data-Driven Palliative Care Model Reduced Hospitalization Rates By More Than 50%
- CMS Rebrands Medicare Advantage Health Equity Index Reward Program As ‘Excellent Health Outcomes For All’
Latest Industry News
- For Medicare Beneficiaries With Dementia, ACO Participation Had No Impact On End-Of-Life Care Processes, Outcomes & Health Spending
- Oregon Releases PACE RFP For Jackson & Josephine Counties
- Payer & Provider Organization Adoption Of Collaborative Care Model For Integrated Mental Health & Medical Care On The Rise Since 2018
- Medicare Accountable Care Organizations Generated From $4.1 Billion To $8.1 Billion In Savings Between 2012 & 2019
- Texas District Court Vacates Federal Minimum Staffing Requirements For Nursing Homes