Medicare Advantage and individual health insurance marketplace plans achieved the best results on certain financial performance indicators in 2023, according to a KFF brief. The researchers leveraged ...

The overall denial rate was 6.4% in 2023, the latest year data was available, according to an analysis by the nonprofit Kaiser Family Foundation. Seniors 65 and older who opt for a private Medicare ...

Sharp Health Plan has begun notifying its patients that it will stop offering its own Medicare Advantage coverage in 2027, a ...

With Medicare Advantage (MA) enrollment surpassing 50 percent of Medicare beneficiaries, accurate risk-adjusted plan payment rates are essential. However, artificially exaggerated coding intensity, ...

In September 2025, a federal judge agreed and invalidated the rule, called the risk adjustment data validation, or RADV, rule ...

Kidney transplant and wait-listing rates were lower for beneficiaries with Medicare Advantage vs. traditional Medicare, according to study data published in JAMA. The 21st Century Cures Act, passed in ...

Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023, reflecting steady increases over the past few years as the number of MA enrollees has grown, according to ...

Forbes contributors publish independent expert analyses and insights. When the most dominant player in a market stumbles, the rest of the industry pays attention. That’s precisely what happened last ...

Medicare beneficiaries using lower-priced negotiated drugs experienced out-of-pocket savings under the Medicare Drug Price ...

Newly released CMS data gives the market its first comprehensive look at how insurers are adapting to continued pressure in the privatized Medicare program. A press release stressing “stability” ...