Sunday Links

Where your genius lives.   More on the new Medicare Advantage telehealth benefit  From Forbes—so it’s what your patients are reading.       Pharma has been unable to stop the new step therapy requirements for meds, so now they’re war-gaming the results. Step therapy requirements will make in-office administration of meds less profitable and therefore less available. Like most things in life, it’s a mix of good and bad.       CMS promises...

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Sunday Links

Al the News That’s Fit to Link     Most of the news this week was in regard to the 2020 final rule, which I discussed in my newsletter this week (sign up, here).   There were still a few tidbits floating around:   An excellent tool for industry-wide enrollment and plan comparison information It’s subscription-based and I don’t get a commission. But it’s fabulous.       A brief, readable summary of insurer’s concerns...

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Sunday Links

Keeping You Ahead of the Curve     Thinking of Starting a Medicare Advantage Plan in 2021? Start Now. I’ve been telling our faithful community that we’ve reached “peak” Medicare Advantage. A month ago in my newsletter, readers will remember about not one but two clients who pulled out of the business of Medicare Advantage plan consulting due to a saturated market. Now a high-quality outfit like Lumeris has to advertise for new business—telling.  ...

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Sunday Links

Knowledge is Power!     “We see the future of Medicare and Medicare Advantage as the same.” Thus spake HHS Deputy Secretary Eric Harden Saw the “mainstreaming” of Medicare Advantage coming 30 months ago when insiders starting jumping on the boards of Medicare  Advantage Organizations—it was one of the things that inspired me to start writing. It’s an enormous sea change from just three years ago—as late as 2015, Medicare Advantage was hated and being defunded...

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Sunday Links

You’re Like Captain Marvel—Only Real!     Here’s a great summary of the comments submitted to CME in response to their 2020 call letter Spoiler alert: Insurance companies are shameless. Someone is paying trolls to suck up to CMS by sending in comments of such slavering support they can only be explained as such.     Of Interest: Medicare Advantage enrollment by state. By Plan     Medicare Advantage plans paid fewer fines in 2018...

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Sunday Links

Your Leg Up Where Medicare Advantage is most popular. Minnesota is #1 due to the dominance of the United and Mayo plans. If you want to see how growth looks in a mature market, that’s the place to follow. Comorbidities, secondary prevention more likely in Medicare Advantage beneficiaries with CAD The headline is misleading, it’s the prevention STRATEGIES that are more likely. Good data on actual prevention is at least a decade away. Of interest,...

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Sunday Links

Extra. Extra. Read All About It.   The pushback against Medicare Advantage in the popular press is growing. To whit:   Fight a denied Medicare Advantage claim ( Chicago Tribune) The Medicare Advantage Advantage for insurers—A sweet deal The Personal Toll of a Medicare Advantage Whistleblower (New Yorker)     Have you noticed movies now have statements in the credit that “the creation of this movie generated 15,000 jobs…” The studios are using their platforms to...

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Sunday Links

The Source of Your Power   Lyft Expands Rideshare Partnerships with MA Plans This is a key, key tactic to improve compliance and prevent no-shows—especially for yearly visits.   I’ve been advocating this with my clients for more than three years now, and it’s the best performing intervention I’ve ever recommended.   Medicare transport has long been a benefit under MA. It’s also long been poorly delivered by third-party vendors—they’re late (when they show up...

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Sunday Links

All the news that fit to link   Private Medicare enrollment soars even as talk of Medicare For All increases From Forbes Every Medicare For All proposal consists of healthcare funded and executed by the government only. No private insurance of any kind. There are pros and cons, but Medicare Advantage is not part of any plan. Not one.     Medicare Advantage growth exploding not slowing Renown Healthcare Anthem Even Google   The narrative...

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Sunday Links

Your Watercooler of Wisdom—for Medicare Advantage!         Industry group America’s Health Insurance Plans (AHIP) details its concerns with recent Medicare Advantage changes. AHIP is an advocacy group for insurers plain and simple. When you want to know what the industry’s take is on a Medicare Advantage issue that’s who you ask.         Written communications to Medicare Advantage recipients from their insurers found to be astonishingly hard to understand. This reflects...

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