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

Didn’t expect the love to become so open, so fast, though.



HealthMatrix creates a website to show off its “best of breeds” for Medicare Advantage Plans

As always, with these “independent” websites, beware of hidden bias and influence—haven’t found anything with this organization, though—yet.

Still, if it relies on STAR ratings, its conclusions will be badly flawed.




Medicare Advantage Plans are Very Bad

Presented as part of my ongoing “pushback” series.




CMS soliciting feedback on how to best levy civil fines

The amounts of such fines are limited by statute based on a plan’s enrollment. They are also not being used with decreasing frequency. I searched the Federal Register and couldn’t find the link to submit comments—email me if you can.




Medicare Advantage patients recieve better secondary prevention treatment—but with no change in clinical outcomes.

Could be we’re spending more money to no additional benefit.  Again, part of my “pushback” series.





You can run your Medicare Advantage contract either by risk-sharing with your primes or not risk sharing with your primes. They are each very different beasts and need to be approached in very different ways—if you want to succeed.