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.

Latest Resources

• Community Care Cooperative Strengthens ACO Network With 10 New FQHCs To Improve Outcomes and Reduce Costs
• Medicare ACOs To Serve 4.4% More Beneficiaries In 2026
• Government Funding Bill Extends Medicare Telehealth Flexibilities & Hospital At-Home
• Maryland Expands Advanced Primary Care To Medicare & Medicaid Members
• Medicare Advantage Plans Denied 4.1 Million Prior Authorization Requests In 2024
• Wider Circle Partners With CalOptima Health To Support Dual-Eligible Members In California
• Real U.S. Health Care Spending Increased 4.6% From 2023 To 2024
• 13.6 Million People Were Dual Eligibles For At Least One Month In 2022
• Federal Data Indicate The Average U.S. Nursing Home Is 25% Short-Staffed
• Older LTSS Recipient Use Of Telehealth Differs Depending On Residence Type
• Alzheimer’s Disease & Related Dementia Are The Third Most Common Hospice Diagnoses
• Data Book: Beneficiaries Dually Eligible For Medicare & Medicaid
• Medicare Hospice Use Patterns Among Patients With Alzheimer’s Disease or Related Dementias Compared to Those With Other Terminal Diagnoses
• Medicare Telehealth Flexibility Expires January 30 Unless Congress Acts
• Medicare FFS Mental Health Telehealth Expansion Helped Maintain Existing Service Use Levels

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Medicare Advantage Beneficiaries With Mental Health Diagnoses Made More Mental Health Visits After Switching To Traditional Medicare

Among Medicare beneficiaries with mental health diagnoses, those who switched from Medicare Advantage to traditional Medicare in 2018 made more mental health visits after the switch, according to a recent study. Researchers conducted a longitudinal analysis of Medicare Advantage encounter data and traditional Medicare claims data from 2017 and 2018 for beneficiaries diagnosed with mental health disorders. The comparison focused on mental health utilization for the 12 months before and after beneficiaries switched from Medicare… Read

• Wisconsin Receives $203 Million In Federal Funding To Support Health Care Innovation, Partnerships In Rural Areas
• Erickson Senior Living’s Medicare Advantage Plan For Residents Earns Top National Ranking For Sixth Consecutive Year
• Provisions Of The Inflation Reduction Act Likely To Destabilize Long-Term Care Pharmacies
• New CMS LEAD Model Aims To Expand Access To Accountable Care, Improve Health Outcomes
• 16% Of Nursing Home Residents Spend Down Savings To Qualify For Medicaid

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