Medicare Advantage Premiums Expected to Fall More Than 16% in 2027
Medicare Advantage premiums are projected to fall more than 16% in 2027 as CMS reports stable plan availability and modest changes in Medicare Part D costs.
CMS
Study Highlights Broader Economic Impact of Food Insecurity Beyond Health Care Costs
A new study finds food insecurity is linked to higher emergency department spending, lower income, and greater job instability, highlighting opportunities for managed care interventions.
CMS Proposes Medicare Home Health Payment Increase and Expanded Fraud Prevention Measures for 2027
CMS has proposed a 2.4% Medicare home health payment increase for 2027 while introducing new fraud prevention measures and updates to the Home Health Prospective Payment System.
Federal Watchdog Finds Widespread Errors in Medicaid Maternal Health Provider Networks
New federal reports found significant inaccuracies in Medicaid managed care provider directories and network lists, raising concerns about access to maternal health services.
Medicaid Managed Care Now Represents More Than Half of Program Spending
CMS has released new Medicaid eligibility rules requiring certain adults to meet work, education, or community engagement standards to maintain coverage beginning in 2027.
CMS Issues New Medicaid Work Requirement Rules, Signaling Major Changes for States and Managed Care Plans
CMS has released new Medicaid eligibility rules requiring certain adults to meet work, education, or community engagement standards to maintain coverage beginning in 2027.
Ohio Suspends Payments to 49 Home Health Providers in Medicaid Fraud Investigation
Ohio has suspended Medicaid payments to 49 home health providers after identifying suspicious billing patterns, marking a major step in the state’s effort to combat fraud and protect taxpayer dollars.
Study Finds Many Medicaid Managed Care Sanctions Remain Unresolved Across States
A new study finds that one in four Medicaid managed care sanctions remain unresolved, raising questions about oversight and accountability in state Medicaid programs.
How States Measure MLTSS Performance: Quality, Oversight, and Accountability
MLTSS is expected to do more than simply move long-term services and supports (LTSS) into managed care. States also use these models to improve coordination, strengthen accountability, and support care in home and community-based settings.
Federal Home Health VBP Model Associated With Reduced Care Disparities For Medicare Beneficiaries With Dementia
A new study found the Medicare Home Health Value-Based Purchasing program was associated with reduced disparities in home health care utilization for beneficiaries living with dementia