Tag Archives: Medicare Advantage

[unable to retrieve full-text content]The following to just part of a longer report by the Physicians for a National Health Program on Medicare Advantage healthcare programs offered by commercial entities. It lays the foundation as to why Medicare Advantage is more expensive than Traditional Medicare. I will do doing the other parts to this report over the next few […] The post Medicare Advantage Overcharging appeared first on Angry Bear.

[unable to retrieve full-text content]Medicare Advantage Plans are notorious for denying healthcare treatments to plan subscribers. CMS is intervening by making a much-needed change to how Medicare Advantage plans decides on treatments needed by plan subscribers. Just a couple of pointers showing how MA has been serving it customers . . . the public. In the existing MA bidding […] The post It will be up to the incoming Trump administration to decide appeared first on Angry Bear.

[unable to retrieve full-text content]I missed this piece from May of this year. Been too busy trying to maintain a blog rather than write or find excellent articles to present at Angry Bear. I apologize for the later. Me writing? you just have to live with it for now till more authors become a regular occurrence here. This piece […] The post Ending Medicare Advantage Overpayments appeared first on Angry Bear.

[unable to retrieve full-text content]There are changes coming to the Medicare market place and Medicare Advantage. “Market exits by Humana, Aetna, and UnitedHealthcare will collectively affect nearly 70% of those 1.8 million individuals.” The remainder of the 1.8 million will be looking at new plans with the same insurance provider. The market exit may be faced with new companies […] The post Heathcare Insurance Companies Abandoning Medicare Advantage appeared first on...

Decoding Medicare Advantage by Andrew Sprung xpostfactoid Can STAT’s exposure of UHC’s exhortations to goose Medicare Advantage enrollees’ risk scores spur action to reduce MA overpayment? Load these Codes It is beyond reasonable doubt that the federal government’s payments to Medicare Advantage plans are grossly inflated by the plans’ gaming of the program’s risk adjustment system, designed to deter plans from cherry-picking health...

by Matthew Cunnigham – Cook The problems with Medicare Advantage is coding and pricing for care. And Fee for Service participants pay for the MA costs even though they do not use MA. “When accounting for favorable selection of enrollees in MA and higher MA coding intensity, we estimate Medicare spends approximately 22 percent more for MA enrollees. This spend is more than if those beneficiaries were a part of FFS Medicare. The difference...

Pretty much a rewrite to provide simpler reading and a better understanding for readers. My rewrite did not make it much shorter. It is taken from a recent 2025 Health Affairs article. The main thrust of this article being commercial Medicare Advantage insurance companies taking advantage of government payments for healthcare to Medicare patients. The other part being CMS doing more to resolve the issues. MA Coding for patients is set the year before...

Don Berwick says MA growth “should be slowed or stopped” Obama CMS Chief Don Berwick: Medicare Advantage Plans Game the System, MedPage Today, Cheryl Clark Ok, this is a long one. It is easy to follow. Donald Berwick is worthwhile read. As written several times on Angry Bear, the biggest driver of healthcare cost is “pricing” increases as reflected in hospitals, pharmaceuticals, and healthcare insurance. It was Dr. Donald Berwick while...

It never ends as commercial interests keep trying to horn in on healthcare for the old geezers like myself. Except, it is not person related healthcare. It is related to the size of your wallet. More on Medicare Advantage by Jake Johnson at Common Dreams. ~~~~~~~~ A right-wing coalition’s proposal to make Medicare Advantage the default enrollment option would be a “clear handout to the private insurance industry,” said one critic. ‘Hell No’:...

Ran across two articles on conservatives, a presidential candidate, and the US Gov. pushing people towards Medicare Advantage plans. I thought I could combine both articles on one post using snippets of information from each. It was too exhausting to do so. I will keep them separate and write each independent of the other. Since I have been writing on healthcare for a while, I typically add my own comments as taken from other sources. This...