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Insurers Nervously Await Proposed Medicare Advantage Rates
The health insurance industry will be closely watching on Friday when the CMS is scheduled to release initial guidance on Medicare Advantage rates for 2015.
The health insurance industry will be closely watching on Friday when the CMS is scheduled to release initial guidance on Medicare Advantage rates for 2015. The trade group America's Health Insurance Plans has been waging an aggressive marketing campaign, called “Seniors Are Watching,” in Washington and beyond to stave off rate cuts.
Insurers anticipate unfavorable news. In a recent filing with the Securities and Exchange Commission, Humana said it expects a cut of 6% to 7% for 2015, up from the 4% to 5% previously anticipated.
But even if the CMS proposes cuts, they won't necessarily go through. Last year, the CMS initially proposed a 2.2% cut. But after heavy lobbying by insurers, the Obama administration—which needs insurance industry support for Obamacare—increased rates by 3.3%.
Read the full story here: http://bit.ly/1f9kTma
Source: Modern Healthcare
Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections
September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
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AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
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