Medicare
The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.
Editor’s Picks
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I/DD-Focused Partnership Solutions Acquires Medicare ACO, Alliance For Integrated Care Of New York
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Operational Difficulties & Low Participation Cause CMS To End Medicare VBID Model Hospice Component As Of December 31, 2024
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Medicare ACOs To Receive $20 Million In Advance Investment Payments
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CMS Adjusts Medicare Policy To Offer Accelerated Payments To Respond To The Change Healthcare Cyberattack, Urges State Medicaid Programs Do The Same
Latest Resources
- Walgreens Plans To Close More VillageMD Locations
- North Carolina Dual Eligible System: An OPEN MINDS State Profile
- Massachusetts Dual Eligible System: An OPEN MINDS State Profile
- Consistent Care Coordination Improves Outcomes For Medicare Advantage Members
- New Contracts, New Services, New Plans – The YTD Update
- Medicare, Medicaid To Cover Wegovy For Consumers With Heart Disease
- 30% Of Surveyed D-SNPs Say States Mandate Which Supplemental Benefits Are Offered, Most Cover Optional Medicaid Benefits
- Alzheimer’s Dementia Prevalence Rises To 6.9 Million In 2024, Cost Of Care Up 4.2% To $360 Billion
- Clover Health & Quartet Health Partner On Clinical Program For SMI
- Clover Health Partners With Quartet Health For Medicare Members With Serious Mental Illness
- CMS Unveils Person-Centered Primary Care Model, ACO Primary Care Flex, For Low-Revenue ACOs
- ACO Primary Care Flex Model: Model Overview Factsheet
- Iowa Behavioral Health Care System: An OPEN MINDS State Profile
- New York Dual Eligible System: An OPEN MINDS State Profile
- Highmark Wholecare Collaborates With Ophelia For Opioid Use Disorder Treatment
Highmark Wholecare is now offering opioid use disorder (OUD) care services through telehealth to its Medicaid and Dual Special Needs Plan (D-SNP) members under a collaboration with Ophelia, an opioid addiction treatment provider. Ophelia has been in-network in Pennsylvania under Highmark Health, the parent company of Highmark Wholecare, since July 2021. Highmark Wholecare has 320,000 Medicaid and 40,000 D-SNP members, who will now have in-network coverage for medication-assisted treatment (MAT) for OUD through Ophelia. Ophelia offers members the… Read
- Insured Consumers Account For 53% Of Provider Organization Bad Debt Write Offs
- HealthPartners – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department Of Human Services, 2024
- Blue Plus – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department of Human Services, 2024
- Firearm Injuries: Health Care Service Needs & Costs (GAO 21-515)
- Operational Difficulties & Low Participation Cause CMS To End Medicare VBID Model Hospice Component As Of December 31, 2024
Latest Industry News
- Consistent Care Coordination Improves Outcomes For Medicare Advantage Members
- 30% Of Surveyed D-SNPs Say States Mandate Which Supplemental Benefits Are Offered, Most Cover Optional Medicaid Benefits
- Alzheimer’s Dementia Prevalence Rises To 6.9 Million In 2024, Cost Of Care Up 4.2% To $360 Billion
- Clover Health Partners With Quartet Health For Medicare Members With Serious Mental Illness
- CMS Unveils Person-Centered Primary Care Model, ACO Primary Care Flex, For Low-Revenue ACOs