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The Decline of PPO in Medicare Advantage

By Arielle Elliott For many seniors, Medicare Advantage PPOs provided a middle ground between the higher costs of MedSupp and the network limitations of HMOs. By the start of last year’s AEP, 40% of MA members (non-SNP, non-EGWP) were in PPO plans. That number had been steadily rising over the...

Adverse Selection No More? Healthy Seniors in MA and MedSupp

Brandon Dunk and Nafisa Ali MedSupp coverage is as comprehensive as you can get—for the not-so-low cost of a monthly premium, qualifying seniors can see any doctor they want as often as they need, no questions asked. That’s a great value proposition for all seniors—but especially high utilizers with preexisting...

Navigating Digital Tools and Healthcare

By Andrew Anthony Digital technology touches nearly every aspect of our lives—from entertainment and the workplace to healthcare and health insurance and beyond. Even within each of these categories there are nearly innumerable forms of digital technology, ranging from more established technologies such as broadcast television or your insurer’s phone...

Seniors, SNPs, and CMS. A Primer on SNPs and the Upcoming 2025PY CMS Final Rule.

By Emily Dykstra Often seniors find the Medicare landscape difficult to navigate. Considering all the differences in plan availability by region and carrier, different programs and costs, some seniors, especially those with limited financial resources, can easily choose coverage that does not best suit their needs. This is especially salient...

What is on the horizon for Medicare Advantage and its supplemental benefit offerings?

By Arielle Elliott The growth of Medicare Advantage in the last decade has reached a new milestone. More than half of all Medicare eligibles are enrolled in Medicare Advantage. To put the speed of this growth in perspective, in 2017, approximately 19 million individuals were enrolled in MA plans (33%...

Exploring the Social Factors Impacting the Under 65 Duals Eligible Market

  By Kyle Janssen Dual eligible Medicare and Medicaid members are, by definition, more in need of assistance with both medical and non-medical needs compared to other consumers. Even among Duals though, there is one group that has more needs and barriers facing them than others—the Duals Under 65 group....