CMS Implements New Regulations to Enhance Medicare Advantage
CMS announces a new final rule for Medicare Advantage and Part D plans to improve consumer protections, prevent deceptive marketing, and enhance behavioral health access.
Healthcare Payers
OIG Report Finds Medicaid Managed Care Fails Mental Health Parity Standards
A recent report from the Office of Inspector General uncovers significant non-compliance with Medicaid managed care mental health parity requirements in eight states, sparking calls for improved CMS oversight.
CMS Unveils Plan to Boost Skilled Nursing Facility Payments and VBP Program
The Centers for Medicare & Medicaid Services announces the ACO Primary Care Flex Model, a new initiative designed to boost primary care within the Medicare Shared Savings Program, starting in 2025.
CMS to Launch New Primary Care ACO Model in 2025
The Centers for Medicare & Medicaid Services announces the ACO Primary Care Flex Model, a new initiative designed to boost primary care within the Medicare Shared Savings Program, starting in 2025.
Wellcare Embarks on Innovative Partnership to Propel Value-Based Primary Care Forward
Wellcare teams up with technology firm Pearl Health to elevate value-based primary care, offering Medicare Advantage beneficiaries improved care quality and cost-efficiency through data-driven insights and collaborative risk management.
CMS Enhances Medicaid HCBS Quality Reporting in Money Follows the Person States
The Centers for Medicare & Medicaid Services mandates early quality measure reporting for states under the Money Follows the Person program, aiming to bolster Medicaid Home and Community-Based Services.
Study Shows That Medicare Advantage Patients Receive Fewer Home Health Visits
A recent study by the University of Washington’s Department of Rehabilitation Medicine exposes significant disparities in home health care between Medicare Advantage and traditional Medicare patients, shedding light on potential impacts on patient independence and caregiver burden.
AHCA and NCAL Released Recommendations to Make ACOs More Accessible for Long Term Care Providers
Discover the innovative strategies proposed by healthcare associations to facilitate greater participation of long-term and post-acute care providers in Accountable Care Organizations (ACOs), aiming to improve patient care and system efficiency.
North Carolina to Launch Specialized Medicaid Managed Care for Vulnerable Populations
Starting July 1, North Carolina introduces specialized Medicaid managed care plans aimed at providing comprehensive care for individuals with mental illnesses, developmental disabilities, substance use disorders, and traumatic brain injuries.
Florida Advances Managed Care for Developmental Disabilities with New Pilot Program
Florida Medicaid announces a tentative decision to award Florida Community Care a contract to test managed care for individuals with intellectual and developmental disabilities, marking a potential shift in care delivery.