Medicare & Medicaid
CMS has been ordered to redetermine the star ratings, which Elevance says should be higher.
The court ruled Humana's compliance costs constitute substantial hardship and denied the DOJ's motion to dismiss for lack of standing.
The ruling could have industry-wide implications for other MA plans seeking to raise their star ratings and bonuses.
MA plans need the correct data because care is not being delivered in front of them, says Anna Basevich, SVP of Enterprise Partnerships and Customer Enablement at Arcadia.
Medicare Advantage may be a victim of its own success as more seniors - and a more sickly population - moves into it.
The groups seek to block a final rule establishing staffing standards.
Initially, efforts with CPESN will focus on enhanced care services for Medicare beneficiaries living with hypertension and diabetes.
Partnership with Valtruis, Blue Venture Fund, Mass General Brigham Ventures and CareSource provides app and individualized care.
Whitehouse and Cassidy called primary care a "critical part" of the healthcare equation, saying it improves outcomes and lowers costs.
The state-level average price has remained above 200% of Medicare for years, though wide variation among states exists.