Medicare 101 for Digital Health Part 1: What is Medicare and how did it get this way?
Mobi Health News
NOVEMBER 24, 2020
An Intro to Medicare - and how Digital Health companies can impact the nation’s biggest payer.
Medicare Related Topics 
Discount drug company Waltz Health moves into Medicare market
Mobi Health News
FEBRUARY 23, 2024
The company will offer a customizable version of its Marketplace Search Technology to health plans supporting Medicare beneficiaries.
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Health Insurance in Aisle 3: Why a Grocery Chain is Working on Medicare
Health Populi
AUGUST 3, 2021
“You can trust us to help you find the right Medicare coverage for you and your lifestyle,” the tagline reads. It is, specifically, Midwest Heritage, Hy-Vee’s banking, insurance and investments subsidiary, that will implement the Medicare Aisle program.
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Medicare 101 for Digital Health Part 2: How digital health companies can gain traction in Medicare
Mobi Health News
DECEMBER 4, 2020
Flare Capital Partners' Gwendolyn Lee & Dr. Dan Gebremedhin highlight digital health startups taking advantage of Medicare and key opportunities within Parts A-D for others to make their mark.
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Medicare Is Cutting 2022 FFS Payments 9.75% & Raising CCM Reimbursements by 54%
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OIG finds $348M in improper Medicare payments for telehealth psychotherapy
Mobi Health News
MAY 8, 2023
According to an audit by the Office of the Inspector General, Medicare improperly paid for $580 million of psychotherapy care, including $348 million of telehealth services, during the first year of the COVID-19 public health emergency.
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Study: Medicare remote patient monitoring use surges during pandemic
Mobi Health News
AUGUST 11, 2022
Researchers found remote patient monitoring use among Medicare beneficiaries increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.
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Contributed: Expanding Medicare Advantage in rural America starts with improving access to care
Mobi Health News
OCTOBER 13, 2022
From hospital closures to physician shortages, provider scarcity is a big challenge when it comes to expanding Medicare Advantage in rural communities.
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Medicare Advantage insurtech company Devoted Health secures $175M
Mobi Health News
JANUARY 2, 2024
The funds come two years after the company scored a $1.15 billion investment.
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Most Americans, Both Younger and Older, Worry About the Future of Medicare and Social Security
Health Populi
JUNE 17, 2024
You would assume that most people over 50 would be worried about the financial future of Medicare to cover health care as those middle-aged Americans age. The most cost-secure are people over 65 (read: Medicare-secure, among two-thirds) and younger people 18 to 29 (6 of whom lack confidence to pay for health care as they age).
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Abbott's FreeStyle Libre 2 CGM picks up Medicare coverage
Mobi Health News
SEPTEMBER 2, 2020
The updated version of the company's system includes automatic alerts when the wearer's glucose is too high or too low.
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What If Costco Designed the Prescription Drugs Sales Model?
Health Populi
JUNE 5, 2022
In 2006 the Medicare Part D program was implemented, covering older Americans for prescription drugs for the first time. Medicare further drove expansion of generic drug utilization, with co-pays for generics lower for Medicare enrollees than branded drugs. While these four actions to lower drug costs garner over 80% of U.S.
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Google adds Medicaid, Medicare enrollment info to Search
Mobi Health News
SEPTEMBER 13, 2022
The tech giant also announces a partnership between YouTube and the Kaiser Family Foundation that aims to help organizations create high-quality informational content on topics like mental health, maternal care and health inequity.
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Medicare Advantage plans received billions from Medicare for home visits. The feds are skeptical
FierceHealthIT
OCTOBER 24, 2024
Medicare Advantage (MA) insurers, namely industry titans UnitedHealth Group and Humana, could be using health risk assessments and chart reviews to inflate payments from Medicare through upcoding, | A federal watchdog is questioning whether UnitedHealthcare, Humana and other Medicare Advantage payers are either creating diagnoses out of thin air to (..)
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Biden proposes Medicare, Medicaid cover anti-obesity drugs
FierceHealthIT
NOVEMBER 26, 2024
The Centers for Medicare & Medicaid Services (CMS) is attempting to cover anti-obesity medications under Medicare Part D and Medicaid, the agency announced Nov.
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Apple, J&J open enrollment of Heartline Study to Medicare seniors with iPhones
Mobi Health News
FEBRUARY 25, 2020
The study will use the smartphones, Apple Watches and a custom health engagement program to influence stroke risk and atrial fibrillation detection.
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Telemedicine, Medicare Advantage and star ratings: What you need to know
Healthcare IT News - Telehealth
JUNE 19, 2023
Over the last few years, Medicare Advantage plans have dramatically increased their deployment of telehealth systems for seniors. While some in the healthcare industry may be skeptical of telehealth’s utilization, particularly within the Medicare population, these plans continue to move full steam ahead.
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Medicare Advantage rate cut remains as feds keep up pressure
FierceHealthIT
APRIL 1, 2024
Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | CMS is not deviating from its January proposal to modestly rein in Medicare Advantage.
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Survey shows seniors are embracing technology and telehealth during pandemic
Mobi Health News
AUGUST 10, 2020
More than 60% of Medicare-eligible seniors say they’ve embraced technology more during the pandemic, according to a new survey from healthinsurance.com.
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Medicare Advantage startup Devoted Health rakes in $1.15 billion in Series D funding
Mobi Health News
OCTOBER 11, 2021
The Series D raise brings Devoted Health’s total funding pot to $1.99
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CMS: Negotiated drug prices would have saved Medicare $6B last year
FierceHealthIT
AUGUST 15, 2024
The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.
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Tech-enabled Medicare-focused primary care provider Iora Health scores additional $126M
Mobi Health News
FEBRUARY 10, 2020
The round was led by Indian firm Premji Invest with participation from Cox Enterprise, Temasek F-Prime Capital, Devonshire Investors,406 Ventures, Flare Capital Partners, Polaris Partners and Khosla Ventures.
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54% of Medicare eligibles enrolled in MA for 2024: KFF
FierceHealthIT
AUGUST 13, 2024
Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.
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Humana exiting Medicare Advantage in 13 markets
FierceHealthIT
SEPTEMBER 4, 2024
Humana reaffirmed its full-year guidance but is leaving 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond said during the Wells Fargo Healthcare Conference on Wedn | Humana is pulling back from Medicare Advantage markets and cutting benefits next year.
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Foodsmart secures more than $200M for telenutrition platform
Mobi Health News
JUNE 28, 2024
The company partners with employers and health plans, such as Medicaid and Medicare, to provide patients virtual access to registered dietitians.
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CVS scoops up tech-enabled Medicare Advantage broker Hella Health
FierceHealthIT
APRIL 30, 2024
CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn. | CVS has quietly acquired Hella Health, a startup Medicare Advantage broker based in New York City, according to a post on LinkedIn.
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Report: Medicare Advantage quality ratings to get new calculations
FierceHealthIT
JUNE 13, 2024
The Centers for Medicare & Medicaid Services (CMS) appears poised to rework Medicare Advantage (MA) quality ratings for this year, The Wall Street Journal
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Cigna trims Medicare Advantage plans in eight states
FierceHealthIT
SEPTEMBER 20, 2024
Cigna is reshaping its Medicare Advantage (MA) plan lineup across eight states, affecting members in 36 health plans. Cigna is the latest company to rethink its Medicare Advantage offerings, choosing to cut plans in eight states including Florida.
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McKinsey: Up to $250B of US health spending could become virtual
Mobi Health News
JUNE 1, 2020
A recent report analyzing claims data identified virtual-care use cases estimates that could comprise roughly 20% of all Medicare, Medicaid and commercial spend across outpatient, office and home health.
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Medicare Advantage star ratings dip slightly once again in 2025
FierceHealthIT
OCTOBER 10, 2024
Just 40% of Medicare Advantage prescription drug plans offered in 2025 achieved a score of four stars or higher, the Centers for Medicare & Medicaid Services (CMS) revealed Oct. It's harder than ever for Medicare Advantage plans to score well on star ratings. Here's how they performed for 2025.
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HHS lowers 64 prescription drug prices under Medicare rebate program
FierceHealthIT
JUNE 26, 2024
Medicare enrollees will pay less for 64 prescription drugs from July though the end of September because drug companies raised prices faster than the rate of inflation, the Centers for Medicare &am | Medicare enrollees will see lower prices this quarter for certain drugs treating cancer and genetic disorders under action unveiled by CMS.
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Humana posts $679M in Q2 profit as it faces continued Medicare Advantage headwinds
FierceHealthIT
JULY 31, 2024
Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage (MA) space. Humana affirmed its guidance for the year as it continues to face headwinds in the Medicare Advantage space.
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Amazon Pharmacy expands RxPass subscription service to Medicare patients
FierceHealthIT
JUNE 17, 2024
Amazon Pharmacy is expanding its prescription drug subscription program, called RxPass, to Prime members on Medicare insurance. | The RxPass program, launched in January 2023, provides unlimited access to 60 eligible generic medications and will ship the medications to customers' homes for a flat monthly fee of $5.
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Feds killed plan to curb Medicare Advantage overbilling after industry opposition
FierceHealthIT
AUGUST 27, 2024
A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)
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CMS: Medicare Advantage, Part D premiums are stable for 2025
FierceHealthIT
SEPTEMBER 27, 2024
Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)
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Fair Square Medicare rolls out AI voice agents to help enroll seniors into insurance plans
FierceHealthIT
AUGUST 14, 2024
Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)
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Uber Health, Socially Determined partner to leverage SDOH data
Mobi Health News
JANUARY 8, 2024
The company will use Socially Determined's analytics data to help Medicaid, Medicare Advantage and commercial insurance patients access food, prescriptions and transportation.
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Brightside Health expanding Medicare and Medicaid telemental health access
Healthcare IT News - Telehealth
FEBRUARY 22, 2024
Brightside Health will be entering into new and expanded payer partnerships to support telemental healthcare access through Medicare and Medicaid, teaming with companies such as Blue Shield of California, CareOregon and Centene.
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CMS proposes new payments for digital health in 2025 PFS draft rule
Mobi Health News
JULY 12, 2024
The proposed 2025 physician fee schedule from the Centers for Medicare & Medicaid Services includes payment and coding for digital health tools for behavioral health.
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MSSP ACOs saves Medicare $2.1 billion in 2023, the largest savings in program history
FierceHealthIT
OCTOBER 29, 2024
Accountable care organizations saved Medicare $2.1 billion, the largest yearly savings in program history, in 2023, the Centers for Medicare & Medicaid Services revealed on Tuesday. Accountable care organizations (ACOs) saved Medicare $2.1
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Medicare hospital trust fund extended by five years to 2036
FierceHealthIT
MAY 6, 2024
The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.
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CMS final rule on broker comp, health equity could shake up Medicare Advantage
FierceHealthIT
APRIL 5, 2024
Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year | Medicare Advantage plans will need to adjust to new star ratings requirements, industry watchers warned following a final rule on Thursday.
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Mental health startup Grow Therapy scores $75M in Series B funding
Mobi Health News
OCTOBER 1, 2022
The new allocation will help the company expand its insurance coverage, including Medicare and Medicaid, across the U.S.
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HealthTap now accepts insurance for virtual primary care services
Mobi Health News
JUNE 17, 2024
The company is now an in-network provider with numerous insurers and commercial and Medicare Advantage plans, expanding its reach to all 50 states.
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