ESRD Enrollment Creates Cost, Network Unknowns for MAOs

Reprinted with AIS Health permission from the July 2, 2020, issue of RADAR on Medicare Advantage. As Medicare Advantage plans prepare to enroll patients with end-stage renal disease (ESRD) this fall, a recent change to network adequacy measurement will give them some flexibility in how they include dialysis care in their networks. Meanwhile, a new lawsuit […]

Pressure Mounts on MA Plans to Address Racial Disparities

Reprinted with AIS Health permission from the June 18, 2020, issue of RADAR on Medicare Advantage As protests erupt across the U.S. calling for racial justice and police reforms, the COVID-19 pandemic continues to bring to light many of the racial disparities in health care, putting pressure on policymakers and the industry to take a hard […]

The Health 202: Trump Administration Lets Medicare Plans Off the Hook

Reprinted from the December 4, 2018, article in The Washington Post  THE PROGNOSIS The Trump administration is holding off on punishing Medicare Advantage plans for error-ridden doctor directories — further evidence the conservative-led Centers for Medicare and Medicaid Services is showing special favor to the alternative program over traditional Medicare offerings. In an audit quietly released late […]