Medicare & Medicaid
The drugmaker, the Biden administration and organizations are calling on other companies to do the same.
By the end of 2021, gross margins per enrollee had returned to pre-pandemic levels in the Medicare Advantage market.
CEO Andrew Toy says the company is achieving "real momentum" toward profitability, and has priced its insurance plans with that in mind.
Apparent differences in potentially avoidable hospitalizations among MA plans may be explained by shifting inpatient care to other settings.
For those with private insurance, coverage for telehealth and other remote care services will vary by plan after the end of the PHE.
CMS says it must examine whether a medication is reasonable and necessary while the FDA assesses whether medications are safe and effective.
This year, Medicare Advantage enrollment grew by just 1.5 million, below the pace set in previous years.
MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe.
Patients in such models were 18% less likely to be admitted to the hospital and had a 9% lower 30-day readmission rate.
On April 1, states can begin disenrolling Medicaid enrollees for the first time since March 2020.