MedPAC sees no broad Medicare Advantage hit to hospital finances
Recent growth in Medicare Advantage (MA) enrollment is not associated with an adverse impact on the finances of hospitals and post-acute care providers, based on findings of an observational study by the Medicare Payment Advisory Commission (MedPAC). However, the shift of beneficiaries from traditional Medicare to MA is affecting providers operationally and could be skewing…
Medicare Advantage turmoil continues
Medicare Advantage (MA) enrollment growth has slowed to its weakest in 15 years, but it remains the dominant Medicare segment. MA enrollment, as of April 1, increased only 2.4% from April 2025, according to an analysis by Mark Farrah Associates. Enrollment increases have slowed from 3.8% in April 2025 and 6.4% in April 2024. The…
Consequences of new MA and ACA Marketplace regulations
Nick and Shawn discuss regulatory changes coming from CMS for the 2027 regulatory season.
One payer argues for more provider risk amid record high hospital volumes: Q&A
In January, two parts of Highmark Health — Allegheny Health Network (the provider) and Highmark (the insurer) — implemented a risk-based payment model for all of Highmark’s commercially insured groups and Medicare Advantage (MA) populations, as well as many of its Affordable Care Act marketplace plans. Bruce Meyer, MD, executive vice president and Western Pennsylvania…