MMIT (Managed Markets Insight & Technology)’s Post

Nation's health care tab projected to hit nearly $8T in a decade Growing demand for care, record levels of insured patients and swelling Medicare enrollment will drive up annual health care spending to $7.7 trillion by 2032, up from $4.8 trillion last year, according to new projections from federal actuaries. https://lnkd.in/eR_2jdrE

Health plans are facing significant challenges due to Medicare headwinds, but AArete is here to help. Their recent insights provide seven robust strategies to address rising costs and patient care demands. 

Are you a payer participating in #MedicareAdvantage? If so, big changes are ahead. Starting in 2027, CMS will reward plans that demonstrate progress in addressing health disparities. What's that mean for your #datastrategy? Arcadia's SVP of Enterprise Partnerships, Anna Basevich, discusses with Healthcare Finance News: https://lnkd.in/dprdN5c7 #healthcaredata

A new report from CMS explores rural-urban disparities in health care in Medicare. The analysis relied upon data from the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys and the Healthcare Effectiveness Data and Information Set (HEDIS). Overall, the report states that people with Medicare living in rural areas had results that were below the national average for the Consumer Assessment of Healthcare Provider and Systems (CAHPS) survey scores for about 20 percent of all clinical care measures examined with rural residents. The analysis also explores variations in racial and ethnic differences in bot rural and urban areas. https://lnkd.in/gVXGHv76

According to a recent KFF survey, more major businesses are considering introducing Medicare Advantage. Since 2017, the number of companies providing retiree health benefits through Medicare Advantage has increased by 26 percentage points. Read more: https://bit.ly/493bNFD #Medicare #MedicareAdvantage

The push for improved health pricing transparency has gained momentum with the endorsement of two bills by various health and employer groups. The Lower Costs, More Transparency Act and the Pharmacy Benefit Manager Reform Act aim to make healthcare pricing more transparent and lower costs. The first bill mandates hospitals to publish their prices, including discounts and negotiated charges, while the second requires pharmacy benefit managers to report detailed pricing information to health plans. These efforts are supported by multiple industry groups to ensure a more transparent and cost-effective healthcare system.

Health system-payer negotiations 'coming to a head': Contract negotiations between health systems and payers are a routine part of doing business, but ongoing cost and workforce pressures, inflation and widespread Medicare Advantage challenges are forcing health systems to push back against the dynamics of the payer-provider relationship. http://dlvr.it/T7cCXN

On September 5, 2023, CMS released a new, voluntary state total cost of care model called the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Healthcare strategy expert Patrick Pilch discusses 5 key considerations that health systems in potential participating states should be aware of: https://ankura.co/3HzLcUd

The Health Equity Index will be a seismic change for Medicare Advantage plans and impact revenue associated with Star Ratings. Melissa Newton Smith and Keslie Crichton BeneLynk join Eric Glazer to discuss how MA plans should prepare.  #MedicareAdvantage #HealthEquityIndex #MA #Stars #medicare #starratings https://lnkd.in/ef5w4C6d

ConcertoCare’s value-based, in-home care model is transforming support for Medicare and Duals members while delivering health plan cost savings. For payers, an investment in ConcertoCare's program pays dividends through reduction of unnecessary ED visits and admissions, prevention of readmissions, and reductions in the need for costlier institutional care. It's a win-win for health plans, their members, and the health system at large.