Medicare Advantage

…And so our goal with health plans over the next year is we're getting ready to scale with a larger health plan of their Medicare Advantage population.…

…Today, we're talking Medicare Advantage, specifically what the latest MA payment rate update looks like, what it means for payers and providers, and what impact it might have on the future stability of the MA program.…

…Like they might have a Medicare Advantage as a, uh, as a significant payer in their clinic, but they don't realize they can get RAP rates to get up to the national rate if they, if they, if they just would set those RAP rates up with the Mac.…

…The contract has its own dispute window and in many agreements, especially Medicare Advantage, the window is shorter than your internal workflows.…

…Portland Metro region and as the administrative lead for the MSO in the office of OHSU Payer Strategy, serves clinicians in a Clinically Integrated Network participating in an MSSP ACO and various Medicare Advantage and commercial value-based care arrangements.…

…And together with coauthors, he has a new article in the May issue of Health Affairs describing, quote, Extreme heat, healthcare use and costs, Evidence from Commercial Insurance, Medicaid and Medicare Advantage.…

…But the other and increasingly more dominant world is what's called Medicare Advantage.…

…uh, CMS launched primary care first to rip the band aid off, uh, primary care capitation, and has opened the window for any other health plan to join, whether that's a commercial plan, another Medicare Advantage plan, a Medicaid managed care plan, or a healthcare.gov plan.…

…In our Medicare Advantage population, as you can imagine, it's a high rate there.…

…so with us we are looking at a model that not only looks at employer groups as a employee benefit, so we're getting those dollars, um, we're looking at it as third party billing through Medicare or Medicare Advantage plans.…

…We initially pinpointed five significant risk areas: Medicare Advantage, Legislative and Regulatory, Finance, Technology, and Burnout.…

…This morning, the Wall Street Journal had an editorial opinion from the editorial board about why the Trump administration was starting to consider auto-enrolling people in Medicare Advantage plans when they became eligible for Medicare.…

…When I was out, I was consulting to Medicare Advantage plans, so I haven't spent a lot of time on the contractor side.…

…of where we'll see activity, I think you're going to see it in value based care, especially in companies that can manage the cost of specialty care as well as in government business, whether it's in Medicare Advantage, managed Medicaid or duals, which is a tremendous opportunity, um, to improve uh, human health, reduce human suffering and create value.…