Navigation Links
Atlantic Information Services’s Medicare Advantage News Reports on Plan Drop-Outs from Massachusetts Dual-Eligibles Demo
Date:7/31/2013

Washington, DC (PRWEB) July 31, 2013

Three of the six health plans selected to participate in Massachusetts’ CMS-funded demonstration program for Medicare-Medicaid dual eligibles recently dropped out, Atlantic Information Services’s Medicare Advantage News (MAN) has learned, largely because of dissatisfaction with the Medicare capitated payment rates on which they had just received data. As reported in the July 25 issue, three other plans are staying in what apparently will be the first of the capitated duals demos to launch, and it looks as though the program will commence on the scheduled Oct. 1 start date. A CMS official confirmed to MAN the information about who is in and out in Massachusetts, but would not elaborate on the specific plan decisions.

The plans choosing to exit the Bay State’s dual-eligibles program include two of the biggest ones selected, albeit not the ones with the most experience in caring for duals. They are a Blue Cross Blue Shield of Massachusetts-led joint venture and Boston Medical Center HealthNet Plan (BMCHP), which is the largest Medicaid managed care organization in the state. The third dropout is Neighborhood Health Plan. Remaining in are Commonwealth Care Alliance, Fallon Total Care and Network Health, which is a Tufts Health Plan unit.

According to MAN, the three defections raise questions about what will happen in the other four states approved for capitated demos so far by CMS and slated to start enrollments in 2014. Many of the issues seemingly arising in Massachusetts — among them uncertainties surrounding large performance “withholds” and costly supplemental benefits that the feds and states expect, as well as concerns about base payment rates — appear to apply as well in those states.

To read the article in its entirety, which also includes analysis from the CEO of one of the plans remaining in the dual-eligibles demo, as well as comment from the exiting plans and other outside observers, visit http://aishealth.com/archive/nman072513-01.

About Medicare Advantage News
Medicare Advantage News is the health care industry’s #1 source of timely news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in this hotly contested area of health insurance. Published biweekly since 1994 (when it was Medicare+Choice), the newsletter exists to help plans boost revenues, increase enrollees, cut costs and improve outcomes in Medicare Advantage and Medicaid managed care.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

Read the full story at http://www.prweb.com/releases/2013/7/prweb10979945.htm.


'/>"/>
Source: PRWeb
Copyright©2012 Vocus, Inc.
All rights reserved

Related medicine news :

1. International conference to explore health of descendants of transatlantic slave trade
2. Dec. 12 Atlantic Information Services Webinar to Address the Nuances of New HHS Essential Health Benefits Regulations
3. Atlantic Information Services Dec. 19 Webinar to Review Just-Ended MA Annual Election Period
4. Maui Wowi Brings Hawaii to the Atlantic
5. Atlantic Spine Center Announces New Web Content on Sciatica Treatment; Renowned Surgeon Dr. Kaixuan Liu on Information and Help for Sciatica Victims
6. Jan. 16 Atlantic Information Services Webinar to Offer a “Crash Course” on New Reform Rules
7. Jan. 17 Atlantic Information Services Webinar Offers Insights on Wall Street’s 2013 Outlook for Health Plans
8. Endless Pools to Showcase Fastlane® at Atlantic City Pool & Spa Show
9. Newly Published by Atlantic Information Services — Dual Eligibles: The New Growth Opportunities Ahead for Health Plans
10. Medicare Expert Will Detail Strategies for Improving Star Ratings in Feb. 20 Atlantic Information Services Webinar
11. PBM Experts to Discuss Non-Rate Contracting Terms in Feb. 25 Atlantic Information Services Webinar
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/8/2016)... ... December 08, 2016 , ... Peter Zipp ... in and around the greater Phoenix metropolitan region, is announcing a charity event ... mission of the Homeless Youth Connection is to promote community awareness of the ...
(Date:12/8/2016)... ... December 08, 2016 , ... Coffey Agencies, ... residential and commercial clients in the northern Alabama and Georgia regions, is embarking ... Since 1977, Nobis Works has built a network of support and education facilities ...
(Date:12/7/2016)... ... December 07, 2016 , ... Students attending Envision’s ... unique opportunity to get hands-on experience in an emergency medical simulation, When Care ... to gain invaluable, real-life medical skills that are critical success in a future ...
(Date:12/7/2016)... (PRWEB) , ... December 07, 2016 , ... ... the drug in their bodies, a researcher at the Icahn School of Medicine ... Research. , The study found that when young children are exposed to secondhand ...
(Date:12/7/2016)... PHILADELPHIA, PA (PRWEB) , ... December 07, 2016 ... ... story of a women growing up with a schizophrenic mother in a unique, ... social worker who specializes in treating trauma and addictive disorders at her private ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... YORK , December 8, 2016 ... focused on the research, distribution, and marketing of pharmaceutical ... affected by patent protection and expiration. Additionally, these firms ... Healthcare sector as a whole. Up for review this ... ), Synergy Pharmaceuticals Inc. (NASDAQ: SGYP ), ...
(Date:12/8/2016)... DES MOINES, Iowa , Dec. 8, 2016 ... STLT), a pharmaceutical company advancing technologies designed to ... the appointment of Chitra Edwin , Ph.D., ... and Compliance. Dr. Edwin will provide leadership for ... planning for regulatory approvals, preparation of regulatory submissions, ...
(Date:12/7/2016)... , Dec. 7, 2016 "Lantus (Insulin Glargine) Biosimilar Clinical Trial ... 37 biosimilar version of Lantus drug in clinical pipeline. Currently 5 biosimilar ... Japan , Kenya , ... , China , Slovakia , ... & 2 diabetes mellitus. The patent on Lantus expired in 2014. ...
Breaking Medicine Technology: