Bamboo Health’s Post

For the first time in Medicare’s history, more than half of all eligible people with Medicare are enrolled in private Medicare Advantage (MA) plans. This shift brings unique challenges for both health plans and providers as they strive to meet value-based care outcomes. Health plans face the pressure of insufficient reimbursement rates, while providers must deliver high-quality, low-cost care. Both need to collaborate effectively to avoid system breakdowns and ensure continuous patient care. Tools like real-time patient insights, shared patient data systems and continuous reporting are crucial for maintaining efficient processes and improving patient engagement. Read our latest blog post to dive deeper into the challenges and solutions for supporting Medicare Advantage plans. https://lnkd.in/eKbJKzn6 #WeAreBambooHealth #VBC #CareCoordination

The move towards #valuebased models will only increase, not only because they ultimately lower costs, but because they give physicians more freedom to focus on the many factors that contribute to patients’ #health outcomes. One of the most telling trend lines highlighted by the Centers for Medicare & Medicaid Services is the significant increase in the number of providers participating in ACOs this year, with 817,000 providers taking part this year versus 700,000 last year. That is progress. Axios - https://bit.ly/3SEhUtE

𝟯𝟮 𝗵𝗲𝗮𝗹𝘁𝗵 𝗰𝗮𝗿𝗲 𝗹𝗲𝗮𝗱𝗲𝗿𝘀 in the nation were featured in this Becker's Healthcare article. Our Chief Medicare Officer, Britta Orr, was among them to highlight how our Allina Health | Aetna Medicare team has transformed its service. Read more at the link in the comments. #HealthCareLeaders #Medicare

Datapoint: Exchange Sign-Ups See 31% Annual Increase: More than 21 million people selected or were automatically reenrolled in health plans during the most recent Affordable Care Act open enrollment period (OEP). That’s according to one of four reports issued by HHS on March 22 marking the 10-ye... Read More #marketaccess #lifesciences #pbm

Health Payers Organization (HPO) isn’t just great for plan members—it’s a game-changer for national and regional health plans, TPAs, and self-insured employers. Explore how HPO’s competitive rates and contract terms benefit both members and plan administrators. Learn more about HPO! #HealthBenefits #NetworkSolutions #OutOfNetwork https://bit.ly/3QhsGEy

Health plans are facing significant challenges due to Medicare headwinds, but AArete is here to help. Their recent insights provide seven robust strategies to address rising costs and patient care demands. 

📊Do you know you know how much your medical plan is overpaying?⚕️🏥 💸💸💸 According to a recent RAND report 📝, in 2022, private insurers paid hospitals an average of 254% more than what Medicare would have paid for the same services. This marks a significant increase from 2020. 📈 Here's the breakdown: Inpatient hospital facility services averaged 255% of Medicare prices Outpatient hospital facility services averaged 289% Associated professional services averaged 188% 🏥💼 The report also highlights wide price variations by state, indicating opportunities for employers to redesign their health plans for better alignment with the value of care provided. Despite recent federal policies on price transparency, many hospitals have yet to comply, and insurer-posted data often lacks clarity.📈💰🏥💼🔍 Takeaway for Employers: With hospitals comprising a substantial portion of health care spending, insights from studies like this offer valuable tools for informed decision-making. Keep monitoring trends, utilization, and spending for better health care management. We are happy to help you understand your current healthcare costs and provide strategies to assist you and your team with curbing and reducing those costs in subsequent years. 📉💰 #BBG #HealthCareCosts #MedicareVsPrivateInsurance #PriceTransparency #EmployerHealthcare #HealthCareTrends

The Biden administration has taken significant steps to advance health equity in America. Two executive orders were signed to ensure that high-quality healthcare is accessible and affordable for all Americans. Executive Order 13985 seeks to pursue a comprehensive approach to advancing equity for all, while Executive Order 14009 aims to protect and strengthen Medicaid and the ACA. These orders are a testament to the administration's commitment to making healthcare accessible to all Americans. #healthcare #healthpolicy #BidenAdministration

Medical Services Authorized by the Veterans Health Administration: Avoid Duplicate Payments In a report, the Office of the Inspector General found that Medicare paid providers for medical services authorized and paid for by the Department of Veterans Affairs’ community care programs, resulting in duplicate payments of up to $128 million. We don’t pay for services authorized under Veterans Health Administration benefits. More information to bill correctly: Medicare Secondary Payer (PDF) booklet https://lnkd.in/gDGWt9bU Medicare Overpayments (PDF) fact sheet https://lnkd.in/grbr2EHJ Section 50.1.1 Medicare Benefit Policy Manual, Chapter 16 (PDF) https://lnkd.in/gY6ThpE4

Understanding Medicare Advantage Plans is more than just a good idea - it's a crucial step towards securing your health in the future. 👍 These plans offer an alternative way to receive your Medicare benefits and often include additional services like vision, hearing, and dental coverage. 👓 By understanding these plans, you can make an informed decision about your healthcare, ensuring you receive the best possible care for your unique needs. 💡 So, what do you know about Medicare Advantage Plans and how have they benefited you or your loved ones? Share your experiences in the comments below! 💬 #MedicareAdvantage #Healthcare #FuturePlanning #InformedDecisions #SecureYourHealth #HealthBenefits #MedicarePlans #VisionCoverage #HearingCoverage #DentalCoverage.