Mark Farrah Associates的动态

Our provider clients are issuing MA RFP’s to payers! Now is the time to reduce the number of Medicare Advantage plans your system contracts with for 2025! Rate cuts are happening, we have our hospital clients issuing RFP’s now to payers to strategically align with 1 or 2 MA plans next year. We can help you develop and execute your MA strategy to eliminate plans, improve yields and educate patients. Let us show you how! Learn more about how to optimize your Medicare Advantage Contracts?? https://lnkd.in/d94uPD_Z #EllsworthConsulting #HealthcareInnovation #ConsultingServices #HealthcareLeadership #PayerNegotiations #HealthcareConsulting #HealthcareManagement #ContractNegotiation #HealthcareContracts #ContractStrategies #ContractSolutions #NegotiationSuccess

Health insurance companies face tough decisions as Medicare Advantage payment rates are reduced. Stay informed about the potential impact on benefits and premiums by reading the full article on the Modern Healthcare blog. #HealthcareIndustry #MedicareAdvantage #ModernHealthcare #YESHIMConsulting

Value-based payments designed to maintain health insurers profits at the risk and expense of physicians and their patients has produced little value. It needs a time-out #TripleAim of #healthcare #KaiserPermanente #patientcenteredcare #publicprivatepartnership #publicprivatepartnerships #healthcarecosts #valuebasedcare #SDoH #HealthEquity #Primarycare #DSNP #FoodIsMedicine #ValuebasedHealthcare #healthcarequalty #Populationhealth #HealthcareReform #HealthcareTransformation #Capitation #Payvider

Heightened regulations and market pressures are forcing Blue Cross and Blue Shield of Kansas City to exit the Medicare Advantage (MA) market by year-end 2024. The insurer will prioritize employer-sponsored health plans, Medicare supplement offerings, and Affordable Care Act plans within the state. Blue KC cited its relatively small MA membership as a key factor in its inability to compete effectively at scale in the current market environment. Learn more: https://hubs.ly/Q02zRJg_0

Minnesota health insurers are proposing premium hikes for individual and small employer plans in 2025. Blue Cross and Blue Shield leads the pack with increases ranging from nearly 8% to nearly 16% across individual and small group markets. The main reason cited for the increases is rising healthcare costs, including increased drug costs, particularly for treatments of chronic conditions, higher reimbursement rates negotiated by hospitals and healthcare providers and increased utilization of GLP-1 drugs for diabetes and weight management. These proposed rates are for unsubsidized plans and don't reflect potential savings from federal tax credits available through MNsure. Minnesota's proposed increases are on the lower end compared to what other states are seeing (5% to 15% range). Final premium figures will be determined by the Minnesota Department of Commerce around September. Learn more: https://hubs.ly/Q02F96xq0

Rising costs in Medicare Advantage? CVS Health is feeling the heat, and you should too. CVS Health just sounded the alarm for 2024. Why? Medicare Advantage costs are climbing, and nobody's quite sure why. This isn't just a CVS issue—it's a wake-up call for the entire insurance sector. As a key player in health care and insurance, CVS Health's decision to recalibrate its expectations speaks volumes. It's a clear sign that we need to dig deeper into the operational challenges and external factors driving these unexpected cost increases. It's critical that we stay ahead of the curve. Understanding these dynamics is not just about adjusting financial forecasts—it's about ensuring the sustainability of Medicare Advantage programs that millions depend on. Let's keep a close eye on how this unfolds. The implications for our industry are far-reaching. For a deeper dive into CVS Health's announcement, check out the full article here: [https://lnkd.in/gqrjdy9v) Navigating these waters will require all hands on deck. Let's get to the bottom of this together. Check this out: https://lnkd.in/gFkd5TyQ

#Medicare Advantage is experiencing a surge in popularity, with enrollment reaching a record 33 million people. However, this growth isn't evenly distributed. While for-profit insurers are thriving, health system-owned Medicare Advantage plans are struggling. They've lost market share, dropping from 17% in 2019 to just 13% in 2024. This trend is further highlighted by several health systems exiting the insurance market altogether, and even closures of individual provider-owned plans. Despite these challenges, some health systems like Trinity Health are bucking the trend and expanding their Medicare Advantage offerings. Learn more: https://hubs.ly/Q02pQdFC0

Thank you to Christy Wilbert, PLCS, AINS for this gem! Check out this week's topic in her "Did you know" series of useful Medicare facts. Coordinating your insurance benefits between Medicare and employer coverage can be tricky.... let's make it even more complicated when you are eligible for Medicare because of disability and under the age of 65. Whether you're an insurance agent, an individual healthcare consumer, or a business owner offering insurance benefits to your workforce, this just highlights the importance of partnering with a brokerage like URL Insurance Group that have in-house experts in ALL health insurance fields whether that's employer sponsored coverage, Medicare, or coverage on a state or federal exchange.

Good news! Oregonians who qualify for Medicare or buy their insurance through the federal marketplace can receive free assistance on their Medicare or marketplace applications in English and other languages! Medicare open enrollment started on Oct. 15 and runs until Dec. 7. Open enrollment for buying individual plans started on Nov. 1 and runs until Jan. 15. #Medicare #OpenEnrollment #Marketplace #Healthcare #Oregon #AffordablePrescriptions #OCAP

Part good news, part bad news: The Centers for Medicare & Medicaid project that spending on health care nationally in 2023 by 7.5% to $4.8 trillion, outpacing the growth of the U.S. economy. One reason is that more Americans than ever (93%) have health insurance coverage, thanks in part to pandemic-related policy choices. Still, healthcare spending increases also are fueled by ever-increasing costs, which remain OAHP’s top concern as we advocate for policies to control costs and keep health care accessible and affordable. Read more in Fierce Healthcare: https://lnkd.in/gyi9iaqQ