Tag Archives: Medicare Advantage

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

By | November 8, 2024

*This post was originally published on KFF Health News on November 8, 2025. It is published with open permission by that site. A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for Medicare & Medicaid… Read More »

Using data-driven quality measurement and analytics to build health equity

By | April 27, 2023

The disproportionate impact of COVID-19 on underserved communities underscored the need for systemic change and renewed efforts to reduce health disparities in people with social risks.  This post describes a partnership between Inovalon and Humana to develop a new health equity composite quality measure to identify disadvantaged populations with the largest care disparities and determine… Read More »

Medicare Advantage Should Be Making News

By | March 3, 2023

Medicare Advantage should be making news. It’s not because the Medicare trust fund continues to run on fumes, which it does. Nor is it because Medicare was taken “off the table” in recent debates about cutting the federal budget, which it was. Rather, it should be getting a lot of attention for new data about its… Read More »

Medicare Advantage and Reimbursement to Address Social Risk Factors

By | June 22, 2020

We don’t always think of health insurers as communicators. However, when insurers set reimbursement rates, they provide information that directly influences service delivery. When payors reimburse for certain services, they are informing providers these services are valued and providing these services is encouraged. When payors do not reimburse for services, or reimburse at lower rates,… Read More »

Options for Universal Coverage: Part 1 – Public vs. Private Provision

With the 2020 US presidential election drawing near, debate about the options for universal coverage will ramp up. At the heart of this debate is the estimated 45% of US adults who are either uninsured or under-insured. They are at risk of experiencing financial hardship or going without needed care in a time when access to… Read More »