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
- The DSP Talent Challenge
- Choose Medicare Act
- Home Health Use Among Dementia Patients Rises—Signals Shift In Medicare Care Trends
- Nearly Half Of Behavioral Health Professionals Declining New Appointments For Medicare &Medicaid BeneficiariesÂ
- The 2025 Federal Budget Reconciliation Bill (H.R.1 – One Big Beautiful Bill Act): Implications For The Health & Human Service Field
- Humana’s CenterWell Business Agrees To Acquire The Villages Health In FloridaÂ
- BlueCross BlueShield Of Tennessee Winding Down Shared Health Subsidiary, With Dual Eligible Plans In Mississippi & TexasÂ
- CMS Rescinds EMTALA Guidance On Emergency AbortionsÂ
- Medicare Advantage Capitation Payments To Increase By 7.2% For 2026Â
- Medicare Beneficiaries With Psychological Distress Made Fewer Outpatient Mental Health Visits After Age 65, But Used More Acute Care ServicesÂ
- Indiana Dual Eligible System: An OPEN MINDS State Profile
- Illinois Dual Eligible System: An OPEN MINDS State Profile
- Home Health Agencies Offering Telehealth Decreased 19% Since COVID-19 Public Health Emergency Ended
- Medicare Advantage Prior Authorization Use Common For Higher Levels Of Behavioral Health Services
- Pennsylvania Dual Eligible System: An OPEN MINDS State Profile
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’s CenterWell Business Agrees To Acquire The Villages Health In FloridaÂ
- BlueCross BlueShield Of Tennessee Winding Down Shared Health Subsidiary, With Dual Eligible Plans In Mississippi & TexasÂ
- Mercy & Humana Partner To Open 65 Prime+ Clinics In MissouriÂ
- Humana & Longevity Health Extend Medicare I-SNP Partnership Through 2030
Latest Industry News
- Home Health Use Among Dementia Patients Rises—Signals Shift In Medicare Care Trends
- Nearly Half Of Behavioral Health Professionals Declining New Appointments For Medicare &Medicaid BeneficiariesÂ
- CMS Rescinds EMTALA Guidance On Emergency AbortionsÂ
- Medicare Advantage Capitation Payments To Increase By 7.2% For 2026Â
- Medicare Beneficiaries With Psychological Distress Made Fewer Outpatient Mental Health Visits After Age 65, But Used More Acute Care ServicesÂ