Ritter Insurance Marketing, Craig Ritter

Best and Worst States for Medicare Advantage Reimbursement in 2017

I ran some analysis of reimbursement rates for 2017.  I took the 4 star and higher reimbursement for each county in the United States and multiplied the reimbursement by the number of MA members in the county.  I did not take into account Regional PPO plans (as that would have been exceedingly difficult), but this…

11 May 16
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eHealth Medicare Membership Grows 42% Year over Year

eHealth’s stock is poised to rise this morning as the company reported strong earnings last night. On the conference call, they shared that their strategy of investing heavily in Medicare, while managing Individual and Family plans for profitability is working quite well. Their overall Medicare membership jumped 42% from 155,000 to over 220,000,…

29 Apr 16
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Early Thoughts on 2017 Medicare Advantage Reimbursement Rates

CMS published their “rate book” for Medicare Advantage reimbursements for 2017. The top line story in the press focuses on one number which is the “average” increase for 2017. The way this works, CMS publishes an advance notice and then the final payment numbers 45 days later. In the advance notice, CMS put out an…

25 Apr 16
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CMS Suspends Star Rating Reduction Policy, Cigna Benefits

In a surprising move, CMS has immediately suspended its Star Rating reduction policy for sanctioned plans. The government organization sent a memo to all Medicare Advantage organizations and Part D plan sponsors on March 8. This Star Rating reduction policy has played a large role in the calculation of Star Ratings for MA and Part D…

23 Apr 16
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Department of Labor releases Final Fiduciary Rule

The final version of the fiduciary rule has landed. The Department of Labor released the amendment to the Employee Retirement Income Security Act in early April. New revisions came on the heels of a December proposal that was met with criticism from the financial industry. Why the need for change? Conflict of interest between…

23 Apr 16
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ACA Enrollment Downgraded Once Again by CBO

An estimated 12 million Americans will buy coverage through Affordable Care Act marketplaces this year. That’s according to the latest report by the Congressional Budget Office. Their ACA enrollment estimate was downgraded from 13 million enrollments predicted in January. This most recent downgrade is hardly surprising. CBO has repeatedly reduced their ACA enrollment estimates…

23 Apr 16
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Independent Health Files Net Loss for 2015

For the second year in a row, Independent Health has filed a net loss with the Department of Financial Services. On April 1, Independent Health reported a $49.3 million loss for 2015. After considering its taxes and investments, its net loss came out to around $44 million. Last year, Independent Health saw its revenue…

23 Apr 16
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Centene and Health Net Merger Approved by Regulators

One of the three major health insurance mergers announced in the summer of 2015 has received all of the approvals it needs to close the deal. The California Department of Managed Health Care and the California Department of Insurance have given Centene and Health Net the green light to combine companies. Centene and Health…

23 Apr 16
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