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

• Many Medicare Advantage & Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks, Inactive Providers
• CMS Clarifies In-Person Requirement For Medicare Mental Health Telehealth Services
• Idaho Dual Eligible System: An OPEN MINDS State Profile
• New Hampshire Dual Eligible System: An OPEN MINDS State Profile
• Many Medicare Advantage & Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks & Inactive Providers
• Delaware Dual Eligible System: An OPEN MINDS State Profile
• Hawaii Dual Eligible System: An OPEN MINDS State Profile
• Largest Health Plans In Each State By Estimated Enrollment: An OPEN MINDS Market Intelligence Report
• Epicured & Fallon Health Announce Partnership To Provide Medically Tailored Meals To Fallon Health PACE Members
• About 56.7% Of Medicare Beneficiaries Eligible For The Medicare Savings Programs Enrolled
• Missouri Dual Eligible System: An OPEN MINDS State Profile
• Complicated Choices
• Oklahoma Behavioral Health System: An OPEN MINDS State Profile
• Wisconsin Dual Eligible System: An OPEN MINDS State Profile
• Kentucky Dual Eligible System: An OPEN MINDS State Profile

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Telehealth Flexibilities Did Not Increase Outpatient Medicare FFS Visit Volume, But Did Result In Lower Post-Visit 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

• California Dual Eligible System: An OPEN MINDS State Profile
• Medicare Advantage SNP Enrollment Grows to 7.3 Million in 2024
• Hospitals Did Not Capture Half Of Patient Harm Events Among Medicare Beneficiaries
• Indiana FSSA Relaunches Its Money Follows The Person Program
• Maryland Medicaid System: An OPEN MINDS State Profile

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