Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
722 signals
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The most expensive gap in care transitions isn’t the readmission, it’s the handoff
Learn why strengthening clinical handoffs—not just reducing readmissions—is key to improving post-acute care, lowering costs and enhancing Medicare Advantage outcomes.
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Out-of-Network claims are costing you more than you think
88% of IDR disputes go to providers. See how health plans can fix OON claims first.
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The next phase of value-based care: policy, technology and what comes next
Value-based care continues to evolve as healthcare organizations balance new policy priorities, growing technology capabilities and the realities of delivering coordinated, patient-centered care. In this episode of Healthcare Insider, host Shannon Mortland sits down with Dan Brillman, deputy administrator at the Centers for Medicare & Medicaid Services (CMS) and director of the Center for Medicaid & CHIP Services (CMCS), and Dr. Rob Bessler, CEO of Honest Health, for a timely discussion on wh...
Policy / Regulatory Changes · 67 signals · last 30 days -
The outpatient shift in surgical care is accelerating
Discover strategies to protect revenue, strengthen physician partnerships and compete as surgical care increasingly moves to outpatient settings.
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Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice c...
Policy / Regulatory Changes · 67 signals · last 30 days -
Louisiana AG says state will investigate Fauci after Senate hearing
Louisiana Attorney General Liz Murrill (R) said her state will investigate Dr. Anthony Fauci after a recent fiery Senate hearing where the retired government scientist pleaded the Fifth Amendment in response to questions from Republican lawmakers. In a post on the social platform X on Saturday, Murrill said that “Louisiana and Missouri deposed Dr. Fauci.”...
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Trump slashes Medicare drug subsidies, cutting against affordability message
The end of a subsidy program that helped keep costs down for Medicare drug coverage could leave millions of seniors with higher monthly costs, a move that undermines the Trump administration's message of cutting drug costs. President Trump often touts his push for access to cheaper drugs through the TrumpRx platform and making “most-favored-nation” deals...
Competitive / Operational Strategy · 38 signals · last 30 days -
CMS News: CMS Announces Nationwide Expansion of Proven Joint Replacement Program
CMS Announces Nationwide Expansion of Proven Joint Replacement Program The Centers for Medicare & Medicaid Services (CMS) is expanding an initiative to improve care coordination for hip, knee, and ankle replacements, ensuring providers work together from pre-surgery education through post-op recovery to promote a seamless patient care experience and optimal health outcomes. Beginning in January 2028, most hospitals will be required to participate in the Comprehensive Care for Joint Replacemen...
Policy / Regulatory Changes · 67 signals · last 30 days -
FY 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final Rule (CMS-1849-F)
FY 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final Rule (CMS-1849-F)
Policy / Regulatory Changes · 67 signals · last 30 days -
OSF HealthCare to pay $552K in HHS settlement over HIPAA
The Health and Human Services Department’s Office for Civil Rights launched an investigation after OSF HealthCare filed a breach report in October 2021.
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How 'physician-led' care team models tackle primary care's workforce problem
Appropriate respect for expertise and independence, plus a shift away from "transactional" pay models, can help bolster primary care delivery, recruitment and retention, experts said in a recent policy panel discussion.
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Weekly Rundown: Counsel Health rolls out white label AI care platform; Community Health Network launches MyChart AI assistant
Stay up to date on the latest in health tech, digital health and health AI news with this weekly brief.
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Health plan customer service reps have AI in their ear
Members may not think they are talking to AI when they call their health plan, but the person assisting them might be. Some insurers have been leaning into member-facing AI capabilities. One of UnitedHealth Group’s 1,000 AI use cases has been using chatbots to handle customer calls, with an AI chatbot initially responding to more […] The post Health plan customer service reps have AI in their ear appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Centene’s buyouts could have a $315M+ price tag for the rest of the year
Centene offered buyouts to most employees in June. Now, the financials are catching up. In a July 28 report, the company projected severance costs between roughly $315 million and $365 million, mostly driven by the voluntary separation program, for the second half of 2026. The company already incurred $61 million in related expenses during the […] The post Centene’s buyouts could have a $315M+ price tag for the rest of the year appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 11 signals · last 30 days -
Alignment Healthcare boasts 32% revenue jump in Q2, lifts 2026 outlook
Executives said the company plans to make further investments in clinical innovation, artificial intelligence solutions and market expansions.
Alignment HealthcareAlignment Healthcare · 2 signals · last 30 days -
Function Health lands $450M in growth financing to scale tech-enabled preventive health
Function Health, a company that offers lab testing and body scans for early disease detection, landed $450 million in growth financing to scale its tech-enabled personalized preventive health services.
SCANSCAN Health Plan · 11 signals · last 30 days -
Texas governor pitches employer health plan option that omits state-required benefits
Texas Gov. Greg Abbott is proposing a new health insurance option for employers that aims to lower premiums by removing certain state-mandated benefits while maintaining federal coverage requirements. The proposal, called the Essential Benefits Health Insurance Plan, would allow insurers to offer employer group plans that satisfy all federal requirements but drop some benefits required […] The post Texas governor pitches employer health plan option that omits state-required benefits appeared...
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Function gets $450M from General Catalyst
Function said it plans to use the funds to expand its subscription-based platform.
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What’s the Hidden Risk in Your Open Enrollment Hiring Strategy?
Open enrollment magnifies workforce decisions. Every delayed hire, every vacant seat, and every compressed onboarding timeline becomes more visible as call volumes increase and members need timely, accurate support. By the time open enrollment arrives, workforce planning has either become a competitive advantage or a race against the clock. Health plans that started early are […] The post What’s the Hidden Risk in Your Open Enrollment Hiring Strategy? appeared first on Becker's Payer Issues |...
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5 insurers stepping back from Medicare Advantage
In recent years, a handful of insurers have left the Medicare Advantage market, and others have scaled back. Medical costs and federal cost-containment efforts have affected MA’s financial viability. For example, ongoing tensions around how star ratings are calculated — and, thus, which plans secure bonus payments — have complicated matters. Amid prior authorization denials […] The post 5 insurers stepping back from Medicare Advantage appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days -
HRSA unveils 340B rebates 2.0
The 340B Drug Discount Program rebate demonstration applies to medicines that represented less than 5.5% of 340B sales in 2025.
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Labcorp raises earnings outlook on strong medical testing demand
The company recently launched a new consumer genetic health panel that analyzes 163 genes linked to cardiovascular issues, metabolic conditions, and hereditary cancer.
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AHA requests CMS reconsider provisions within Medicaid community engagement rule
The AHA July 31 provided comments to the Centers for Medicare & Medicaid Services on its interim final rule on Medicaid community engagement requirements. To be eligible for or maintain Medicaid coverage, the rule requires certain adults to complete 80 hours per month of “qualifying activities,” such as employment, education, community service or participation in a work program, or meet equivalent income thresholds. The AHA shared concerns about two provisions that it said could increase proc...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS releases FY 2027 final rule for long-term care hospitals
The Centers for Medicare & Medicaid Services today finalized a 2.3% payment update for long-term care hospitals for fiscal year 2027 relative to FY 2026. This includes a 3.2% market basket update, reduced by a 0.9 percentage point productivity adjustment. In addition, CMS finalized its decision to freeze the outlier threshold at $78,936, the same level as FY 2026. For the LTCH Quality Reporting Program, CMS finalized the removal of two measures related to COVID-19 vaccination and a shortened...
Policy / Regulatory Changes · 67 signals · last 30 days -
Providers miss payer policy changes until revenue falls: 6 report findings
Payer policy changes that are not reflected in contracts are the leading source of revenue leakage for providers, according to a July 29 report from Trek Health in partnership with the Healthcare Financial Management Association. The report is based on a survey of 161 healthcare leaders at hospitals, health systems and other provider organizations. It […] The post Providers miss payer policy changes until revenue falls: 6 report findings appeared first on Becker's Payer Issues | Payer News .