Tag: Medicare Advantage

MHA Monday Report Feb. 13, 2023

Monday Report
MHA Monday Report

MHA Board of Trustees Reviews State and Federal Advocacy Options to Further Strategic Priorities

The MHA Board of Trustees began its Feb. 8 meeting with a federal advocacy briefing from federal lobbyist Carlos Jackson with Cornerstone Government Affairs. Jackson highlighted the policy and funding threats and opportunities healthcare providers …

capitol buildingFiscal Year 2024 Executive Budget Recommendation Released

Gov. Whitmer released her executive budget recommendation Feb. 8 for fiscal year 2024. The proposed budget fully protects traditional hospital line items for Medicaid and the Healthy Michigan program, continues targeted rate increases from recent budget cycles and includes …

MHA and Rural Members Advocate on Capitol Hill

The MHA and rural hospital leaders visited Capitol Hill in Washington D.C. Feb. 7-9 to advocate for specific rural healthcare policies as part of the National Rural Health Association’s Rural Health Policy Institute event. …

Registration Available for MHA Keystone Center Safe Patient Handling Conference

Registration is now open for the MHA Keystone Center Safe Patient Handling Conference. The all-day event will take place April 13 at the Ann Arbor Marriott Ypsilanti at Eagle Crest. In partnership with the MHA Keystone Center, EarlyMobility.com …

January MA Enrollment Increases by 33,000 Beneficiaries

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.25 million in January, an increase of 33,000 beneficiaries since October. The January enrollment is spread across 48 MA plans that are currently operating in the state, …

The Keckley Report

Paul KeckleyWave Two Value-Based Care: The Five Market Shifts that Will Reset the Payment Environment for Providers

“Wave One of the Value Based Care environment was marginally effective: CMS’ alternative payment models showed promise but savings to Medicare fell short of expectations per MedPAC. Medicare Advantage enrollment grew but plan sponsors were overpaid by Medicare. Hospital avoidable readmissions and complications efforts have been successful but the pandemic economy decapitated hospital resources necessary to compete in the value-based environment. Wave One is a mixed bag. …

The Wave Two Value Agenda in U.S. healthcare will impact every player and be messy. The backdrop of the 2024 Campaign cycle and post-pandemic economy mean impetus will shift from resource-constrained Medicare to the private sector as both offer significant but distinct opportunities for lower spending. And the revolution of generative AI assures shortcomings of the system—diagnostic error, administrative waste, fraud—will be widely exposed. …”

Paul Keckley, Feb. 6, 2023

News to Know – Feb. 13, 2023

  • Prospective payment system hospitals are reminded that any requests for corrections to the January public use file data being used by the Centers for Medicare and Medicaid Services to develop the fiscal year 2024 Medicare wage index must be received, along with supporting documentation, by the Medicare Administrative Contractor by Feb. 15, 2023.
  • The MHA is offering its popular Healthcare Leadership Academy program on March 13-15 and May 15-16.
  • MHA Endorsed Business Partner Demand Workforce/Qodex will host a free 30-minute webinar on Mission Impossible: Let’s Talk About How to Heal Your Staffing Crisis at noon ET Feb. 22 to discuss healthcare trends in staffing including creative approaches to deliberately using your nursing workforce.

MHA in the NewsMHA CEO Brian Peters

The MHA received media coverage the week of Feb. 6 regarding a variety of topics, including the fiscal year 2024 executive budget recommendation, the role food insecurity has as a social determinant of health, the new state House Behavioral …

October MA Enrollment Increases by 17,000 Beneficiaries

Member News

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.22 million in October, an increase of 17,000 beneficiaries since July. The October enrollment is spread across 48 MA plans that are currently operating in the state, with approximately 56.5 percent of Michigan’s 2.15 million Medicare beneficiaries covered by an MA plan. With up to 48 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on July enrollment.

Members with questions should contact Katie Jaskolski at the MHA.

Hospitals Encouraged to Review Medicare Advantage Enrollment Plans

Member News

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.2 million in July, an increase of 15,000 beneficiaries since April. The July MA enrollment is spread across 47 MA plans that are currently operating in the state, with approximately 56% of Michigan’s 2.1 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 30 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county based on July enrollment. In addition to the 47 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Katie Jaskolski at the MHA.

Medicare Advantage Enrollment Continues to Rise

Member News

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.18 million in April, an increase of 23,000 beneficiaries since January. The April MA enrollment is spread across 46 MA plans that are currently operating in the state, with approximately 56 percent of Michigan’s 2.1 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 31 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on April enrollment.  In addition to the 46 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Katie Jaskolski at the MHA.

Medicare to Cover Over-the-counter COVID-19 Tests for Beneficiaries

Member News

The Centers for Medicare & Medicaid Services is developing an initiative that will provide free access to eight over-the-counter (OTC) COVID-19 tests per month for Medicare beneficiaries. The initiative will apply to individuals enrolled in both traditional Medicare and Medicare Advantage (MA) plans. The new initiative will result in tests approved by the U.S. Food and Drug Administration being available through eligible pharmacies and other participating entities with payment directly from Medicare. Until the initiative is implemented, which is anticipated in early spring, Medicare beneficiaries can access free tests through other channels, including:

  • Requesting four free OTC tests for home delivery at the government’s dedicated webpage.
  • Accessing COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. The Department of Health and Human Services provides a webpage to search for community-based testing sites.
  • Accessing PCR tests and antigen tests performed by a laboratory at no cost when the test is ordered by a physician, nonphysician practitioner, pharmacist or other authorized healthcare professional. In addition, Medicare beneficiaries can access one lab-performed test without an order, also without cost sharing, during the public health emergency.

MA plans may also offer coverage and payment for OTC COVID-19 tests as a supplemental benefit; MA beneficiaries should check with their plan on whether it includes this benefit. More information is provided in a frequently asked question document on the CMS website. Members with questions may contact Vickie Kunz at the MHA.

Medicare Advantage Enrollment Continues to Rise

Member News

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.12 million in October, an increase of 13,000 beneficiaries since July. The October MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 49 percent of Michigan’s 2.3 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 28 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county, based on October enrollment.  In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.

Medicare Advantage Enrollment Continues to Rise

Member News

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1,107,000 in July, an increase of 12,000 beneficiaries since April. The July MA enrollment is spread across 45 MA plans that are currently operating in the state, with approximately 48% of Michigan’s 2.3 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 27 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county based on July enrollment. In addition to the 45 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Kellen Teel at the MHA.