Showing 1 to 12 of 13 results
Medicare Advantage: Informed Consent for Better Understanding
This article highlights the lack of transparency in Medicare Advantage plans and advocates for informed consent to help beneficiaries make informed decisions, using examples of unexpected costs and network issues.
Medicare Advantage: Informed Consent for Better Understanding
This article highlights the lack of transparency in Medicare Advantage plans and advocates for informed consent to help beneficiaries make informed decisions, using examples of unexpected costs and network issues.
Progress
44% Bias Score
Justice Department Launches Criminal Probe into UnitedHealth's Medicare Billing
The Department of Justice is conducting a criminal investigation into UnitedHealth Group, the nation's largest private health insurer, for potential Medicare fraud related to its Medicare Advantage program, following earlier civil investigations and reports of doctors being pressured to submit claim...
Justice Department Launches Criminal Probe into UnitedHealth's Medicare Billing
The Department of Justice is conducting a criminal investigation into UnitedHealth Group, the nation's largest private health insurer, for potential Medicare fraud related to its Medicare Advantage program, following earlier civil investigations and reports of doctors being pressured to submit claim...
Progress
44% Bias Score
Humana's Q1 Profits Surge on Improved Medicare Advantage Cost Control
Humana announced $1.2 billion in first-quarter profits, exceeding expectations, driven by improved medical cost management in its Medicare Advantage plans, which saw its benefit expense ratio decrease to 87.4% compared to 89.3% last year, alongside increased premiums and revenue growth in its Center...
Humana's Q1 Profits Surge on Improved Medicare Advantage Cost Control
Humana announced $1.2 billion in first-quarter profits, exceeding expectations, driven by improved medical cost management in its Medicare Advantage plans, which saw its benefit expense ratio decrease to 87.4% compared to 89.3% last year, alongside increased premiums and revenue growth in its Center...
Progress
40% Bias Score
UnitedHealth Cuts 2025 Forecast Despite Strong Q1 Earnings
UnitedHealth Group's Q1 2025 earnings report revealed a $6.3 billion net income and $109.6 billion in revenue, but the company lowered its 2025 earnings per share forecast due to unexpectedly high Medicare Advantage utilization and reduced federal spending, causing a significant stock drop.
UnitedHealth Cuts 2025 Forecast Despite Strong Q1 Earnings
UnitedHealth Group's Q1 2025 earnings report revealed a $6.3 billion net income and $109.6 billion in revenue, but the company lowered its 2025 earnings per share forecast due to unexpectedly high Medicare Advantage utilization and reduced federal spending, causing a significant stock drop.
Progress
40% Bias Score
2024 Healthcare: Mergers Rise, Politics Silent, MA Enrollment Grows
In 2024, the US presidential election largely ignored healthcare, while hospital mergers increased, Medicare Advantage continued growing, and digital health funding decreased; however, new startups emerged.
2024 Healthcare: Mergers Rise, Politics Silent, MA Enrollment Grows
In 2024, the US presidential election largely ignored healthcare, while hospital mergers increased, Medicare Advantage continued growing, and digital health funding decreased; however, new startups emerged.
Progress
44% Bias Score
Medicare Advantage Insurer, Analytics Firm Pay $100 Million in Fraud Settlement
A Western New York health insurer, Independent Health, and its data analytics partner, DxID, will pay $100 million to settle Justice Department allegations of fraudulent billing for exaggerated or nonexistent health conditions in their Medicare Advantage plans, highlighting vulnerabilities in the sy...
Medicare Advantage Insurer, Analytics Firm Pay $100 Million in Fraud Settlement
A Western New York health insurer, Independent Health, and its data analytics partner, DxID, will pay $100 million to settle Justice Department allegations of fraudulent billing for exaggerated or nonexistent health conditions in their Medicare Advantage plans, highlighting vulnerabilities in the sy...
Progress
48% Bias Score
UnitedHealth Profit Plunges on Rising Healthcare Costs
UnitedHealth Group reported a $3.4 billion profit decline in Q2 2025 due to increased healthcare costs across Medicaid, Medicare Advantage, and ACA plans; the company projects earnings growth to resume in 2026, revising its 2025 outlook accordingly.
UnitedHealth Profit Plunges on Rising Healthcare Costs
UnitedHealth Group reported a $3.4 billion profit decline in Q2 2025 due to increased healthcare costs across Medicaid, Medicare Advantage, and ACA plans; the company projects earnings growth to resume in 2026, revising its 2025 outlook accordingly.
Progress
40% Bias Score
MAHA Movement to Leverage Health Insurance Brokers for Nationwide Health Improvement
The Make America Healthy Again (MAHA) movement, led by HHS Secretary Robert F. Kennedy Jr., aims to utilize nearly one million health insurance brokers to improve U.S. health outcomes by incentivizing preventive care, addressing concerns about high broker commissions, and promoting behavior change a...
MAHA Movement to Leverage Health Insurance Brokers for Nationwide Health Improvement
The Make America Healthy Again (MAHA) movement, led by HHS Secretary Robert F. Kennedy Jr., aims to utilize nearly one million health insurance brokers to improve U.S. health outcomes by incentivizing preventive care, addressing concerns about high broker commissions, and promoting behavior change a...
Progress
56% Bias Score
CMS Raises Medicare Advantage Reimbursement Rate by 5.06%, Adding $25 Billion
CMS raised the 2026 Medicare Advantage reimbursement rate by 5.06%, adding $25 billion, reversing previous cuts that eliminated plans covering 1.5 million beneficiaries in 2025 and led to higher costs and fewer benefits; CMS also withdrew a proposal to expand coverage for obesity drugs.
CMS Raises Medicare Advantage Reimbursement Rate by 5.06%, Adding $25 Billion
CMS raised the 2026 Medicare Advantage reimbursement rate by 5.06%, adding $25 billion, reversing previous cuts that eliminated plans covering 1.5 million beneficiaries in 2025 and led to higher costs and fewer benefits; CMS also withdrew a proposal to expand coverage for obesity drugs.
Progress
44% Bias Score
Medicare Advantage Prior Authorizations: Lower Denial Rates, But Persistent Issues
Medicare Advantage prior authorization practices, though controversial, have lower denial rates (6.4 percent in 2023) than perceived; however, appeals are frequently successful (over 80 percent), and the system causes significant administrative burdens.
Medicare Advantage Prior Authorizations: Lower Denial Rates, But Persistent Issues
Medicare Advantage prior authorization practices, though controversial, have lower denial rates (6.4 percent in 2023) than perceived; however, appeals are frequently successful (over 80 percent), and the system causes significant administrative burdens.
Progress
52% Bias Score
Elevance Health Acquires Indiana University Health Plans, Expanding Medicare Advantage Presence
Elevance Health acquired Indiana University Health Plans, adding 28,600 members (19,000 Medicare Advantage and 9,600 commercial) to its Anthem Blue Cross and Blue Shield operations in Indiana, reflecting a national trend of hospital systems exiting the insurance market and increasing consolidation i...
Elevance Health Acquires Indiana University Health Plans, Expanding Medicare Advantage Presence
Elevance Health acquired Indiana University Health Plans, adding 28,600 members (19,000 Medicare Advantage and 9,600 commercial) to its Anthem Blue Cross and Blue Shield operations in Indiana, reflecting a national trend of hospital systems exiting the insurance market and increasing consolidation i...
Progress
48% Bias Score
Public Anger at Health Insurers Despite Positive Ratings
Public reaction to the murder of UnitedHealthcare CEO Brian Thompson revealed deep anger towards health insurers despite a KFF survey showing that most Americans rate their health insurance positively; this highlights the perverse financial incentives in the system, favoring profit over patient care...
Public Anger at Health Insurers Despite Positive Ratings
Public reaction to the murder of UnitedHealthcare CEO Brian Thompson revealed deep anger towards health insurers despite a KFF survey showing that most Americans rate their health insurance positively; this highlights the perverse financial incentives in the system, favoring profit over patient care...
Progress
52% Bias Score
Showing 1 to 12 of 13 results