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Humana Plan Year 2020 Certification and Recertification Details Announced!

Posted by www.psmbrokerage.com Admin on Tue, May 14, 2019 @ 10:04 AM

Humana Certification & Recertification Course Details for Plan Year 2020!

Humana 2020 Certification Info Header


It’s already that time of year to start preparing for AEP 2020 and Humana is here to help. We are excited to announce that we will be launching certification and recertification courses earlier than ever before this year! Both courses will launch at noon Eastern Time on June 25, 2019

Our team listened to your feedback and has made some changes to help improve your experience this year.

Top 4 Improvements:

  1. This will be the earliest cert and recert launch date in Humana MarketPoint history!
  2. Certification Course outlines will be reduced by almost half while maintaining training quality and making it more efficient for you to complete your certification.
  3. Both the certification and recertification final exams are open book, and for PY20 we are making it easier than ever to find the information you need to pass the test.
  4. The time to complete the final exam (both cert and recert) will be extended from 35 minutes to 45 minutes

Certification & Recertification Launch Dates
All PY20 Certification and Recertification courses will launch Tuesday June 25, 2019 at noon EST.*

*NOTE: Does not include Spanish translation.  Spanish versions will be available on a delayed basis. Look for additional communications on Spanish versions.

Recertification Completion Deadlines

  • Internal agents will have until 5:00 PM Eastern time on September 30, 2019 to complete Recertification.
  • External agents will have until 5:00 PM Eastern time on November 30, 2019 to complete Recertification.


Ahip Information

 

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Tags: Humana, Medicare Advantage, Medicare, certification

Industry Updates: Medicare Supplement Market Premium Grows 4.9% to $32.4 Billion

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 04:04 PM

CSG Actuarial Blog Header

By Taylor McDonald – CSG Actuarial – May 7, 2019

CSG Actuarial, with information from the NAIC and other sources, reports total earned premiums in the Medicare Supplement market in 2018 totaled $32.4 billion, a 4.9% increase over 2017. The total Med Supp lives covered in 2018 increased to 14.05 million, up 3.9% from 2017. The top 12 carriers in terms of 2018 Medicare Supplement premiums were:

1 United Healthcare
2 Mutual of Omaha
3 Anthem
4 HCSC
5 CVS Health
6 Cigna 
7 CNO Financial
8 BCBS of Massachusetts
9 Humana
10 Wellmark
11 BCBS of Michigan 
12 BCBS of Florida

The 2018 overall Med Supp market loss ratio of 79.0% reflects a continued trend in the market of the overall loss ratios creeping back up towards “Pre-Modernized” levels of around 80%.

Source: https://www.csgactuarial.com/2019/05/industry-updates-medicare-supplement-market-premium-grows-4-9-to-32-4-billion/

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Tags: Humana, Cigna, Medicare, Medicare Supplement, UnitedHealthcare, CSG Actuarial, aetna, mutual of omaha

Humana Sees Population Health Gains for Medicare Advantage Members

Posted by www.psmbrokerage.com Admin on Mon, Apr 29, 2019 @ 04:02 PM


 

The Bold Goal program has improved population health for Humana Medicare Advantage members since 2015.

By Jessica Kent – HealthPayerIntelligence – April 25, 2019

Medicare Advantage members living in Humana’s seven original Bold Goal communities have seen an improvement in population health, with these individuals experiencing a 2.7 percent reduction in their Unhealthy Days since 2015, according to Humana’s 2019 Bold Goal Progress Report.

Humana’s Bold Goal program aims to improve the health of the communities it serves 20 percent by 2020 and beyond. Since the program began, Humana has used the CDC’s health-related quality of life measurement, known as Healthy Days, to track and trend progress.

Healthy Days takes the whole person into account by measuring self-reported physically and mentally unhealthy days over a 30-day period. The healthy days measurement aligns with the Bold Goal’s aim to address individuals’ physical well-being, along with the social determinants of health, such as food insecurity, loneliness, and social isolation.

San Antonio, the first Bold Goal community, is halfway to its 20 percent healthier goal, with members in this area experiencing a 9.8 reduction in unhealthy days. Humana worked with community organizations, physician practices, and others to screen 500,000 members, employees, and patients for social determinants of health in 2018, leading to the gains in everyday wellness.

The report stated that on average, a Humana Medicare Advantage member who is food insecure may experience 26.6 unhealthy days, while Medicare Advantage members who experience loneliness may see an average of 24.4 unhealthy days.

Humana noted that of those experiencing food insecurity, 66 percent have to choose between food and medical care. Food insecure members are also 50 percent more likely to be diabetic and 60 percent more likely to have congestive heart failure.

Those experiencing loneliness and social isolation are four times more likely to be re-hospitalized within a year of discharge, and 64 percent more likely to develop dementia.

These non-clinical influences can also have detrimental effects on mental health. For those Bold Goal communities that did not see significant improvements in population health, Humana stated that one of the contributing factors was a higher number of mentally unhealthy days versus physically unhealthy days.

“Throughout the country, we are seeing a rise in mental health concerns as well as loneliness and social isolation, especially in our aging adult population. In fact, since the 1980s, the rates of loneliness in adults over the age of 45 have doubled,” said Caraline Coats, Vice President of Bold Goal and Population Health Strategy.

“With the knowledge that mentally unhealthy days and new membership are driving many of our results, several of our Bold Goal communities are looking at ways to address this growing need. We’ve already seen efforts emerge in Tampa Bay, New Orleans and Louisville.”

In Louisville, Kentucky, the Louisville Health Advisory Board’s Behavioral Health Committee trained more than 2200 volunteers in emergency response techniques designed to prevent suicide.

The Tampa Bay Bold Goal Health Collaborative has also been focused on addressing the behavioral health needs of members, partnering with mental health professionals, faith-based organizations, and other stakeholders.

In addition to the social determinants of health, the Bold Goal program aims to improve population health by managing chronic conditions. Nearly 77 percent of Americans aged 65 or older are living with two or more chronic conditions, the report said, making chronic disease management imperative for overall health.

“A large part of Humana’s focus is to help people living with multiple chronic conditions improve their health, which requires an integrated approach,” said Bruce D. Broussard, Humana’s President and CEO.

“The Bold Goal is not just our north star; it’s a quantitative way for us to address the holistic needs of multiple populations, and to measure our progress. This year’s report reflects our track record of success in managing chronic conditions over time. Given current demographic trends, we expect to see continued demand for a support structure that addresses social needs, along with clinical ones.”

In Knoxville, Tennessee, the Knoxville Health Advisory Board has focused on addressing diabetes, which has led to positive trends for low-income Humana Medicare members. These individuals experienced a 2.9 reduction in unhealthy days in 2018.

Going forward, Humana and its Bold Goal communities will continue to address the many factors that influence well-being, with an understanding of the important roles physical, mental, and social elements play in members’ overall health.

“The social barriers and health challenges that our Medicare Advantage members and others face are deeply personal,” said William Shrank, MD, Humana’s Chief Medical Officer.

“This requires us to become their trusted advocate that can partner with them to understand, navigate and address these barriers and challenges. With Healthy Days as our barometer, we are able to track and trend population health, measure outcomes and triage members in unique ways to the resources they need.”

Source: https://healthpayerintelligence.com/news/humana-sees-population-health-gains-for-medicare-advantage-members

 
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Tags: Humana, Medicare Advantage, Medicare

Humana launches nationwide value-based cancer care program

Posted by www.psmbrokerage.com Admin on Wed, Apr 17, 2019 @ 03:17 PM



As part of its effort to shift more of its business towards value-based care arrangements, Louisville-based insurer Humana has launched a national Oncology Model of Care program meant to drive better treatment of cancer patients across the country.

Through the program – which targeted at both Medicare Advantage beneficiaries and commercial members – Humana will support better care coordination and health outcomes through financial incentives.

The insurer said it will provide compensation for better care navigation based on quality and cost metrics across various parts of the patient journey ranging from inpatient admissions, ED visits, prescription drugs, diagnostics and radiology.

Humana lists 16 providers as inaugural participants in the program including multiple members of The US Oncology Network, along with health systems and practices like Cincinnati-based Tri Health and Kentucky’s Baptist Health Medical Group.

While the CMS Innovation Center has developed its own Oncology Care Model, the program is focused on episodes of care surrounding chemotherapy administration.

Humana is hoping to improve general cancer care for patients over the period of a year by emphasizing more face time between physicians and patients, access to proactive health screenings and the increased use of data analytics to better coordinate care around patients.

The new oncology program is the payer’s fourth specialty-care payment model, alongside bundled payment programs for Medicare Advantage spinal fusion patients and total joint replacement patients, as well as maternity care bundled payment programs for commercial group members with low-to-moderate risk pregnancies.

Humana has more than 2 million Medicare Advantage members and around 115,000 commercial plan members who are cared for by primary care physicians in value-based payment relationships.

In the company’s 2018 report on its value-based care practices, Humana found that MA members with physicians in value-based care relationships experienced 7 percent fewer emergency room visits and 5 percent fewer hospital admissions

Medical costs for patients who were affiliated with physicians in Humana MA value-based agreements were also 15.6 percent lower than traditional Medicare.

Humana’s recent activities are indicative of the larger payer industry making a full-scale business transition to value-based care.

Case in point, UnitedHealthcare is launching a Care Bundles program next year that will offer providers across 30 states the option of participating in bundled payment arrangements for eight medical procedures for MA patients.

Source: https://medcitynews.com/2019/04/humana-launches-nationwide-value-based-cancer-care-program/

 
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Tags: Humana, Medicare Advantage, Medicare

Likely return of the health insurance tax to impact MA profits

Posted by www.psmbrokerage.com Admin on Mon, Mar 04, 2019 @ 04:44 PM

Likely return of the health insurance tax to impact MA profits

By Susannah Luthi – ModernHealthCare – March 1, 2019

Congress appears unlikely to delay the health insurance tax next year. If that happens, Medicare Advantage plans would see the biggest impact, analysts and insurers say.

On Wednesday, a bipartisan group of House lawmakers introduced a suspension of the tax, known as the HIT, through 2021. The tax was in place for 2018, suspended in 2019 and is due to take effect again in 2020.

But as House lawmakers unrolled their proposal for another delay, senior congressional staff from both chambers and parties said they don't think it's likely to move before insurers start setting their ACA exchange rates next year.

One senior GOP aide said it's unclear how any of the smaller tax delays will get done, "let alone the big spending health care extenders."

Some insurance executives have been bracing for the possibility they won't get their delay. But they also haven't given up on urging Congress to step in and eliminate the tax or continue the moratorium from 2019.

In a quarterly earnings call in January, UnitedHealth Group CEO David Wichmann warned that the return of the HIT would increase healthcare costs by a total $20 billion for 142 million people.

"That causes the average senior couple to see their premiums raised by $500 per year and for families with small business coverage by about the same amount, around $480 or so per year," Wichmann said. "Our view is that outcome is unacceptable because healthcare already costs too much."

S&P analyst Deep Banerjee said a return of the HIT wouldn't necessarily affect insurers' profit margins for Affordable Care Act individual market exchange plans, where companies can pass the fee on to their customers through higher premiums.

However, he said, insurers are less likely to take this approach in the more lucrative Medicare Advantage market where competition between plans is so tight they don't want to risk losing enrollees.

The push for the HIT delay comes after the eight largest publicly traded insurance companies reported more than $21 billion in net income for 2018 on top of revenue of $718 billion, according to analysis by Modern Healthcare. Despite the HIT being in effect in 2018, insurers' earnings benefited from low medical cost trends, lower utilization of healthcare services, declining pharmacy costs and a lower tax rate, according to a report released Thursday by A.M. Best.

In a sign that Medicare Advantage insurers are worried about the HIT's potential impact on their markets, Humana CEO Bruce Broussard told investors earlier this month the HIT moratorium allowed Humana and the rest of the industry to make significant investments in benefits and drive better health outcomes, but its return will reverse that. "The return of the HIF in 2020 will negatively impact seniors across the nation in the form of reduced benefits and/or higher premiums," he said.

Broussard, during the company's first earnings call for 2019, said this is driving their lobbying push.

"We are working with partners to urge Congress to take legislative action to repeal the HIF for 2020 and beyond, recognizing that there is a sense of urgency given the rapidly approaching deadline for submitting bids for 2020 Medicare Advantage offerings," Broussard said.

On the flip side, UnitedHealth CFO John Rex in January indicated that the company is so diversified it's unlikely to feel a financial squeeze, warning that instead the tax would add to the cost burden of the insured.

"I'd be remiss to diminish $2.6 billion of our customers' funds just having been paid for the health insurance tax," Rex said. "That's still a very significant number for any company, I would say, and a burden for our customers."

In terms of the HIT's impact on premiums, Oliver Wyman Actuarial Consulting last year projected a likely increase of just over 2% annually. The firm predicted the biggest increase for Medicare Advantage — $241 per MA enrollee versus a $196 increase per person in the ACA individual market.

A senior Democratic aide said while there's been preliminary discussions on the staff level, the legislation doesn't seem to have a good chance of a House floor vote anytime soon.

And Rep. Earl Blumenauer (D-Ore.), who sits on the House Ways and Means Committee's tax policy and health panels, said this is partially because all the insurance taxes are figuring into the committee's broader discussion over where they want to go with taxes.

"For me, I don't think it's a good idea to be spun out on individual details until we've heard the big picture," the congressman told Modern Healthcare.

"There's a big agenda in terms of trying to deal with tax issues, and I think you don't want to deal with these things piecemeal until we find out where we're at, because they all interrelate," he added.

Reps. Ami Bera (D-Calif.), Josh Gottheimer (D-N.J.), Jackie Walorski (R-Ind.) and Kenny Marchant (R-Tex.) led the House proposal to delay HIT through 2021. Sens. Cory Gardner (R-Colo.), Jeanne Shaheen (D-N.H.), John Barrasso (R-Wyo.), Doug Jones (D-Ala.), Tim Scott (R-S.C.), and Kyrsten Sinema (D-Ariz.) led the Senate version in January.

Source: https://www.modernhealthcare.com/politics-policy/likely-return-health-insurance-tax-impact-ma-profits

Image: Freepik

 

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Tags: Humana, Medicare Advantage, UnitedHealthcare

Walgreens Partnership Boosts Humana's Medicare Enrollment

Posted by www.psmbrokerage.com Admin on Mon, Feb 11, 2019 @ 10:49 AM

Walgreens Partnership Boosts Humana's Medicare Enrollment

Walgreens-Humana

By Bruce Jepsen – Forbes – February 7, 2019

Humana says its joint venture with Walgreens Boots Alliance is helping boost enrollment in Medicare Advantage, the fast-growing privately administered health coverage for U.S. seniors.

Humana reported a 9% increase in Medicare Advantage membership the health insurer attributed to physicians at more than 230 clinics including two sites inside Walgreens stores. It’s the latest sign showing the early stages of a joint venture between Humana and the nation’s largest drugstore chain is working and could be expanded beyond a pilot in the Kansas City market.

"Our 233 owned, joint ventured and alliance clinics, the majority of which are payer agnostic, including our two 'Partners in Primary Care' clinics inside Walgreens stores experienced positive results in the annual election period," Humana CEO Bruce Broussard told analysts Wednesday during the company's fourth quarter earnings call.  "Humana MA membership grew over 9% in these clinics in the (annual election period) excluding the more mature Conviva clinics."

Humana, which has invested hundreds of millions of dollars acquiring and partnering with medical care providers in recent years, said its relationships helped it take Medicare Advantage market share away from rival insurers. Humana said it expects 2019 individual Medicare Advantage membership growth of “375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday as part of its fourth-quarter 2018 earnings release.

Walgreens and Humana last year opened “senior-focused primary care clinics” inside drugstores as a way to complement Walgreens pharmacy services and Humana’s Partners in Primary Care centers that opened last year in Kansas City. The effort is designed in part to keep people out of the more expensive hospital setting and make sure Medicare patients have their care more closely monitored by Walgreens pharmacists and physicians in Humana’s health plan networks.

The two companies think they can do a better job of reaching patients who visit Walgreens retail locations and making sure they get better care upfront before they get sick. When the partnership was announced, Walgreens and Humana called it “a senior-focused neighborhood approach to health that brings together primary care, pharmacy, in-person health plan support and other services for Medicare beneficiaries.”

The Medicare Advantage growth is key for Humana, which is in a competitive battle with rival insurers like Aetna, UnitedHealth Group and Cigna, looking to tap into a market of more than 10,000 baby boomers aging into the Medicare population every day.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/07/humana-walgreens-clinic-venture-boosts-medicare-enrollment/#1ce9cb783f39

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Tags: Humana, Cigna, Medicare Advantage, Medicare, UnitedHealthcare, aetna, Walgreens

Humana To Add Nearly 400K Seniors To Medicare Advantage Plans

Posted by www.psmbrokerage.com Admin on Thu, Feb 07, 2019 @ 11:11 AM

Humana To Add Nearly 400K Seniors To Medicare Advantage Plans

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By Bruce Jepsen – Forbes – February 7, 2019

Buoyed by growth in Medicare Advantage enrollment, Humana is the latest insurer to report solid fourth quarter profits as seniors flock to private coverage sold via contracts with the federal government.

The health insurance industry is tapping into a market of more than 10,000 baby boomers aging into the Medicare population every day. Humana is the latest insurer to report Medicare Advantage growth that is slightly ahead of the projected record growth the Centers for Medicare & Medicaid Services (CMS) predicted for Medicare Advantage last fall.

Following the recent open enrollment period, Humana expects 2019 individual Medicare Advantage membership “growth of 375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday.

The additional membership comes as Humana and its historic rivals like UnitedHealth Group and Aetna expanded their Medicare Advantage offerings into new regions and several startup plans and new competitors emerged.

But Humana CEO Bruce Broussard said the insurer did a good job holding its own while taking Medicare Advantage business away from rivals he didn’t name during a Wednesday morning call to discuss earnings with analysts.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017, the insurer said Wednesday. The performance helped the Louisville-based provider of health insurance and outpatient medical care increase net income to $436 million, or $2.58 per share in the fourth quarter of last year. That compares to $490 million, or $1.29 per share in the fourth quarter of 2017. Revenue rose to nearly $14.2 billion.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/06/humana-to-add-nearly-400k-seniors-to-medicare-advantage-plans/#35f430fa1013

Image: Freepik

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Tags: Humana, Medicare Advantage, Medicare

Humana expects more than 700K will drop out of Part D plans as market competition heats up

Posted by www.psmbrokerage.com Admin on Wed, Feb 06, 2019 @ 03:15 PM

Humana expects more than 700K will drop out of their Part D plans


By Paige Minemyer – FierceHealthCare – February 6, 2019

Humana is expected to bleed a significant number of members from its Part D plans, as greater competition has chipped away at the company’s market share. 

Brian Kane, Humana’s chief financial officer, said on the company’s earnings call Wednesday morning that the insurer expects to lose between 700,000 and 750,000 members in its stand-alone Medicare prescription drug plans in 2019. That is a decrease in projections from November, when Humana estimated that as many as 800,000 people could drop from its Part D rolls. 

As more competitors have entered the Part D market, Humana’s plans are no longer consistently the lowest cost, which is leading some members to switch to other insurers, Kane said. Humana is now working to “innovate” the value proposition in their plans. 

“While it will take time, we intend to stay competitive,” CEO Bruce Broussard said. 

Though Humana expects a downturn in enrollment in its Part D plans, it is still projecting about 4.5 million enrollees in those plans, according to its earnings documents. 

Policy changes in Part D add another wrinkle to this discussion, Kane said, but Humana is rethinking its approach in that market irrespective of how proposals play out. 

That said, should the Department of Health and Human Services finalize its plan to end drug rebate protections in Part D for the 2020 plan year, that change would be “material” and would have significant implications for how these plans function, he said. 

The biggest risk, he said, is a potential adverse selection in pricing if the approach to negotiation is fundamentally changed. In addition, Humana is also concerned that the policy change is likely to drive up premiums in Part D plans. 

Though Humana reported a downturn for enrollment in its Part D plans, its Medicare Advantage business was a bright light in 2018 and is a key source of the company’s momentum heading into the 2019 fiscal year. 

Medicare Advantage a bright spot

Humana reported a 6% increase in revenue for 2018, reaching $56.91 billion compared to $53.77 billion in 2017. Fourth quarter revenues were also on the rise, totalling $14.07 billion, a 7% uptick from $13.10 billion in Q4 2017.

As the health insurance fee was pushed off to 2020, Humana was able to invest significantly in improved service for its MA plans, Broussard said. The Centers for Medicare & Medicaid Services set strong rates for MA in the 2019 plan year, as well, he said, so that growth is expected to continue this year.

Humana expects to add 370,000 to 400,000 seniors to its MA plans in 2019, increasing its membership by 12% to 13%. Kane said the company also expects to add about 30,000 people to its group Medicare Advantage plans. 

“We are pleased with the consistency of ongoing improvement in our performance,” Broussard said.

Source: https://www.fiercehealthcare.com/payer/humana-expects-more-than-700k-will-drop-out-part-d-plans-as-market-competition-heats-up

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Tags: Humana, Medicare Advantage, Medicare, Medicare Part D

Industry support gathers for expanding MA benefits in 2020

Posted by www.psmbrokerage.com Admin on Wed, Feb 06, 2019 @ 03:01 PM

Industry support gathers for expanding MA benefits in 2020

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By Amy Baxter – HealthExec – February 5, 2019

Since CMS proposed expanding supplemental benefits for Medicare Advantage for the 2020 plan year at the end of January, several industry groups have voiced their support, seeing opportunities to improve care for individuals with chronic illnesses and lower costs.

The proposal allows MA plans––which are private health insurers that contract with Medicare to provide all healthcare services under original Medicare––more flexibility to design benefits centered around specific chronic conditions. CMS previously expanded supplemental benefits for the 2019 plan year to include services such as in-home care, which can keep older adults out of acute care settings and improve health and wellness.

The new expansion, if finalized, would enable plans to cover more benefits that directly address social determinants of health, such as home modifications, transportation and meals. For people with chronic conditions, addressing these issues can prevent or delay more serious health events. The benefits would also extend to those affected by opioid addiction seeking treatment.

“Meeting the needs of patients with chronic disease requires a team-based approach to care,” president and CEO of the American Medical Group Association (AMGA), Jerry Penso, MD, MBA, said in a statement following the proposal. “This also may include services that traditionally were not thought of as healthcare-related, including ones that deal with socioeconomic barriers to care. That is why AMGA is supportive of CMS’ effort to provide flexibility in how Medicare Advantage plans in order to help support the total needs of a patient by, for instance, ensuring their nutrition and transportation needs are met.”

The expanded benefits could help attract more Medicare beneficiaries to MA plans if plans include them in their 2020 bids. Over the next several years, MA enrollment is expected to significantly rise. In 2019, enrollment is anticipated to reach an all-time high of 22.6 million, or 36.7 percent of all Medicare beneficiaries, according to CMS.

With this in mind, Matt Eyles, president and CEO of association group America’s Health Insurance Plans (AHIP), is taking a close look at the proposal and its potential impact.

“We appreciate the ongoing bipartisan commitment from both Congress and the Administration to protect the Medicare Advantage program — ensuring its long-term stability, so that it can continue to improve seniors’ access to quality, affordable health care that meets their individual needs,” he said in a statement. “We will continue to review the advance rate notice carefully and look forward to participating in the comment period.”

Better Medicare Alliance, which advocates for MA through healthcare policy and research, also plans to comment on the proposal and voiced stronger support for the expansion of the supplemental benefits to people with chronic illness and those affected by opioid addiction.

“We are encouraged by CMS’ proposals to allow Medicare Advantage plans and providers greater flexibility to meet the needs of chronically ill beneficiaries with the expansion of supplemental benefits,” BMA President and CEO Allyson Y. Schwartz said in a statement. “Evidence has shown that beneficiaries in Medicare Advantage experience lower rates of opioid use. CMS’ proposals will build on this success by increasing access to effective treatments for opioid addiction and promote non-opioid therapies available in Medicare Advantage.”

Source: https://www.healthexec.com/topics/policy/industry-support-gathers-ma-benefits-2020

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Tags: Humana, Medicare Advantage, Medicare, UnitedHealthcare, aetna, CVS, WellCare

As Democrats Talk Single Payer, Private Medicare Advantage Soars

Posted by www.psmbrokerage.com Admin on Wed, Feb 06, 2019 @ 02:42 PM

Medicare Advantage Enrollment Surges


By Bruce Japsen – Forbes – February 5, 2019

Health insurers are reporting unprecedented growth in the number of seniors flocking to private Medicare Advantage plans amid talk of a single payer government-run approach that could uproot such coverage.

The same week U.S. Sen. Kamala Harris (D-California) made news with her support for “Medicare for All,” insurers Anthem and Cigna reported strong growth from Medicare Advantage, private coverage sold via contracts with the federal government.

Anthem’s Medicare Advantage enrollment jumped by 35% to more than 1 million at the end of 2018 compared to 746,000 in the fourth quarter of 2017, the operator of Blue Cross and Blue Shield plans reported last week. “Our individual Medicare Advantage business is on track to achieve our mid-double digit growth target,” Anthem CEO Gail Boudreaux told analysts during the company’s fourth quarter earnings call last week. “In total, we estimate our Medicare Advantage growth will exceed 20% by the end of 2019.”

Meanwhile, Cigna reported Friday that its Medicare Advantage enrollment was up one percent to 436,000 from 432,000 and UnitedHealth Group ended 2018 with 4.9 million Medicare Advantage enrollees, which was up nearly 12% from 4.4 million at the end of 2017. Other insurers including Aetna, which is now part of CVS Health, are expected to report higher Medicare Advantage enrollment later this month after these plans expanded into new markets.

The industry is tapping into a market of more than 10,000 baby boomers aging into the Medicare population every day . The insurers that have reported 2018 earnings thus far are reporting overall industry growth that’s slightly ahead of the projected record growth the Centers for Medicare & Medicaid Services (CMS) predicted for Medicare Advantage last fall. “We completed a strong Medicare Advantage enrollment season . . . and are on track to achieve 2019 growth within the 400,000 to 450,000 range of expectations,” Steve Nelson, CEO of UnitedHealthcare, UnitedHealth’s insurance business told analysts two weeks ago.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

As seniors flock to Medicare Advantage, analysts say it’s going to make it difficult for Democrats on the presidential campaign trail to support a Medicare for All approach that would bring an end to the private insurer’s role.

The insurance industry worries most about so-called “single payer” forms of health insurance that would conceivably replace the private insurer’s role with a government-administered form of coverage. U.S. Sen. Bernie Sanders of Vermont has espoused the single payer approach for years but the Medicare for All Act of 2017 that he, Harris and others supported does mention “the ability to enroll in a Medicare Advantage plan.”

America’s Health Insurance Plans, the health insurance lobby that includes Anthem, Cigna and other insurers that sell Medicare Advantage, said Americans don’t want a “a one-size-fits-all health care system.”

“Today, health insurance providers deliver coverage that is working for hundreds of millions of Americans – including 180 million Americans who are covered through an employer, 20 million covered through Medicare Advantage, 55 million covered through Medicaid managed care, and 20 million who buy their own coverage,” AHIP spokeswoman Kristine Grow said.

”The vast majority of these 300 million Americans are satisfied with their existing coverage," Grow added. "One of the reasons they like their coverage is it provides them with choice and control. Health care is personal – all Americans are unique individuals with different health care needs depending on their stage of life, where they live, their income and resources, and physical and mental health. People should be able to get the care they need, when they need it, at a cost they can afford.”

Source: https://www.forbes.com/sites/brucejapsen/2019/02/03/as-democrats-talk-single-payer-private-medicare-advantage-soars/#71a5c29458f3

 
Additional Updates:
 

Tags: Humana, Medicare Advantage, Medicare, UnitedHealthcare, aetna, CVS, WellCare

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