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Review of Contract Year 2020 Medicare Advantage supplemental healthcare benefit offerings04 November 2019 - By Catherine M. Murphy-Barron and Eric Buzby - Article

In the past two years, CMS has expanded the types and flexibility of supplemental benefits Medicare Advantage organizations (MAOs) can offer enrollees. This issue brief discusses the implications of actions taken by plans in response.

The Medicare Advantage Value-Based Insurance Design Model: Overview and considerations19 February 2019 - By Catherine M. Murphy-Barron and Pamela M. Pelizzari and Brian Regan - Article

This research brief describes the Value-Based Insurance Design model for Medicare Advantage organizations (MAOs) and explores key considerations for eligible MAOs considering participation in the model.

Review of Contract Year 2019 Medicare Advantage supplemental health care benefit offerings06 December 2018 - By Catherine M. Murphy-Barron and Eric Buzby - Article

A review of the number of Medicare Advantage plans that are taking advantage of new flexibility by offering new types of benefits in 2019.

Premium support models for Medicare: Practical considerations17 October 2017 - By Catherine M. Murphy-Barron and Pamela M. Pelizzari - Article

This paper describes some of the key financial and insurance issues involved in premium support proposals for Medicare Parts A and B.

How CMS payments to Medicare Advantage plans differ for ESRD beneficiaries versus other Medicare beneficiaries13 September 2017 - By Catherine M. Murphy-Barron and Eric Buzby - Article

The Medicare Advantage (MA) benchmark for beneficiaries with end-stage renal disease (ERSD) is calculated using a less refined methodology than that used for other Medicare beneficiaries, and it is likely that the MA benchmark for an ERSD beneficiary in any one plan is not a true representation of the expected fee-for-service cost of providing Medicare services for that beneficiary.

Regulatory oversight in Medicare Advantage24 June 2016 - By Catherine M. Murphy-Barron and Gabriela Dieguez - Article

This report explores the body of rules and regulations that affect Medicare Advantage bids, revenue, and benefit design.

Analysis of cancer care under the ACA risk adjustment methodology22 January 2016 - By Catherine M. Murphy-Barron and Howard Kahn and Rong Yi - Article

An analysis on actual claims data using stochastic simulations to model if the Patient Protection and Affordable Care Act of 2010 (ACA) risk adjustment is able to fully compensate carriers for adverse selection on cancer claims.

New insurance regulations on providers participating in alternative payment arrangements02 September 2015 - By Catherine M. Murphy-Barron and Howard Kahn and Rebecca L. Johnson and Robert Parke - Article

A recent growing trend has been to shift insurance (utilization) risk from payers to providers through alternate payment contracts (APCs) in an effort to align financial compensation with performance and financially penalize providers if certain financial and quality thresholds are not met.

Healthcare, provider reimbursement, and the changing financial terrain19 March 2015 - By Catherine M. Murphy-Barron and Rebecca L. Johnson - Article

Healthcare providers should start thinking about strategies for defending and gaining market share sooner rather than later.

Individual health insurance exchanges: What we know, what we don’t know, and looking ahead to 201516 December 2013 - By Catherine M. Murphy-Barron and Hans K. Leida and Victoria Boyarsky - Article

It will be several years before insurers have the claim data they are accustomed to.

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