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Tag Archives: Medicare Advantage
As a follow up to my last article on the Notice of Intent to Apply, I give you an enhanced chart of 2019 application activities outlining things you should have been doing or should be in the middle of now. Thanks to the Centers for Medicare & Medicaid Services (CMS) for creating a base, published on Friday via memo – my colorful additions peppered throughout for your perusal. If past activities have not been done yet, it is time to get a move on, or you risk missing the deadline. Read more
Here are three planning questions you need to ask yourself right now:
- Are you losing market share because you are not offering the right products or product mix?
- How could the profitability of your Medicare Advantage (MA) enrollment change if you expanded your service area?
- Is now the time to begin offering an MA plan?
I worked on single-payer healthcare legislation for US Rep. John Conyers (D-MI), my hometown Congressman from Detroit and an early leader on the issue with Rep. Jim McDermott (D-WA) in the 90’s. It’s not surprising the idea has gone nowhere in the 26 years since. While my heart is in it as a means of universal coverage, Bernie’s “Medicare for All” proposal as dropped this week is a conversation piece, and that’s it. It’s DOA as legislation.
A little section in the Medicare Access and CHIP Reauthorization Act (MACRA) is bringing big changes to Medicare supplemental insurance, also known as Medigap, bought by more than 12 million seniors to help fill in the coverage holes in traditional Medicare. In the vast majority of cases, Medigap purchasers augment their coverage with a Medicare Part D Prescription Drug Plan (PDP). That means MACRA’s changes will cause a seismic event in senior markets – Medicare Advantage, Medigap insurers, and PDPs – nationally, starting now.
Program audits and oversight activities must be designed with many factors to balance: accuracy, consistency, efficiency, and in an effort to be least disruptive to a plan sponsor. Correspondingly, a plan should be tailoring its response to these audits with those same factors in mind. My colleague Deb Devereaux and I outline ten common risk areas we observe in plans large and small. Read more
It was a hot summer night when the Centers for Medicare & Medicaid Services (CMS) released the final version of the calendar year 2018 Medicare Marketing Guidelines (MMG), and a few hot summer days have passed while the industry digests the changes. Don’t make the mistake and only share the MMG with sales and marketing; those handling enrollment, customer service, mailings, printing, Star Ratings and quality, compliance and oversight, legal affairs, provider relations, and finance (including delegates handling these functions) all have a stake in this chapter.