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All posts tagged with “Regulatory News | Medicare.”
Shifting focus to MA will alter ‘life as we know it’ for home care providers, experts say
12/08/23 at 04:00 AMShifting focus to MA will alter ‘life as we know it’ for home care providers, experts sayMcKnight’s Home Care DailyDecember 7, 2023Medicare Advantage is disrupting the traditional home care landscape, experts from the Research Institute for Home Care said in a webinar hosted Wednesday afternoon by the National Association for Home Care & Hospice. As MA continues to dominate Medicare and cover those beneficiaries receiving home health, certain trends—such as access issues or shifting utilization rates for services within traditional Medicare—have become more pronounced. “Medicare Advantage is growing, and that’s going to result in a decreased volume in home health claims among traditional Medicare beneficiaries,” Elizabeth Hamlett, senior research associate for evaluation and health economics at KNG Health, said during the webinar about the recently released 2023 RIHC [Research Industry for Home Care] Chartbook. Home health users in general also may become more reflective of the characteristics of MA beneficiaries—which essentially means sicker and poorer, she said. ... However, MA and fee-for-service beneficiaries showed greater variation in their reported access to home health services. “What we’re seeing here is potentially an access problem for Medicare Advantage users,” Hamlett said.
Here’s why you can’t die peacefully in Oklahoma.
12/08/23 at 04:00 AMHere’s why you can’t die peacefully in Oklahoma.By Abby RemmingThe OklahomanDecember 6, 2023... Having Medicare or a Medicare Advantage plan would cover hospice, but many people have private insurance from work or state Medicaid plans. Private insurance and Medicaid Advantage plans at times can have a hospice benefit but limit which companies can be used. Applying for Medicare will ensure you are covered for hospice. ... I currently work as a hospital social worker and assist many people who need hospice. Many times, I have had to share with patients and their families that, while they may be ready to peacefully pass away, hospice coverage is not included in the patient’s current insurance plan. Providing end-of-life care is extremely difficult without the added burden of worrying whether insurance will cover the benefit. Those without the benefit and who need the service are then reliant upon the generosity of the companies to absorb the cost. If the Medicaid Advantage plan is picked, a person would need to decide if they wanted the benefit to either cover nursing home care or in-home hospice care. A Medicaid Advantage plan might not cover hospice even when the policyholder believes they have the benefit.
The Medicare Gold Rush Is Slowing Down
12/08/23 at 03:19 AMThe Medicare Gold Rush Is Slowing DownWall Street JournalDecember 6, 2023The popularity of private Medicare plans has been a huge driver of profits for insurance companies in recent years. There are signs the gold rush isn’t quite what it once was. ... The most immediate red flag came from the industry leader, UnitedHealth. During an investor day last week, it predicted its Medicare Advantage enrollment would grow by 450,000 to 550,000 seniors in 2024. That translates to around 5% growth next year, a significant slowdown from the 11% it grew so far this year, according to TD Cowen analyst Gary Taylor. As UnitedHealth executives were presenting in New York, The Wall Street Journal reported that the second-largest Medicare plan provider, Humana, was in merger talks with Cigna. While Cigna’s interest in Humana surely attests to insurers’ continued desire to expand into the Medicare market, some investors took it as a sign that Humana isn’t so sure about the strength of the business going forward.