Medicare Advantage

Work

A Look at PACE Growth by the Numbers: States, Organizations, and Enrollment

Our primer on the Program of All-Inclusive Care for the Elderly (PACE) – a capitated health plan that provides comprehensive Medicare and Medicaid covered services to frail, older adults in the community who are eligible for nursing home care – explores the latest enrollment trends and highlights latest opportunities for PACE growth.
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Work

An Evaluation Framework for Assessing Nonmedical Supplemental Benefits in Medicare Advantage

After five years of growth of nonmedical supplemental benefits, there are significant gaps in our knowledge and the data around these benefits, especially from the perspectives of Medicare beneficiaries. Action must be taken to close data gaps so that policymakers have the information necessary to assess and, if needed, refine these benefits to align with their original intent to support the needs of individuals with complex chronic conditions. ATI Advisory and Long-Term Quality Alliance, with support from the SCAN Foundation, created the Evaluation Framework to chart a path for multiple stakeholders – including plans, policymakers, and researchers – to provide timely insights on Medicare Advantage enrollee needs, understanding, access, and experience of benefits; to enhance plan capabilities to collect and use data to improve benefit offerings; and to build the evidence base on nonmedical benefits’ effects.
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Work

Opportunities to Advance Nursing Facility Quality of Care Through Medicare-Medicaid Integration 

This issue brief explores the attributes of a potential Medicare-Medicaid integrated model focused on ensuring high quality and high value care for dual eligible long-stay nursing facility residents. We identify policy opportunities for CMS and states to consider to facilitate a Medicare-Medicaid model in nursing facilities, including increasing payment transparency, promoting alignment between Medicare and Medicaid quality measures, and requiring that a percentage of plan payment go towards value-based contracts with nursing facilities. Taken together, these model elements could meaningfully improve experiences for dual eligible individuals living in nursing facilities, and for their families.
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Webinars

Value-Based Care in 2024: Anticipating Key Trends and Transformations

Brian Fuller, Managing Director of ATI Advisory’s Value-Based Care Design and Delivery practice, shared his observations on the evolution of value-based care during the webinar, “Value-based care in 2024: Anticipating Key Trends and Transformations.” 
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News

The Inflation Reduction Act Is Not Impacting Pharma R&D – Yet

Forbes columnist uses ATI Advisory analysis as basis for his latest column: "ATI Advisory was pretty thorough in compiling data for the first six months of 2023 using published information on 18 leading companies with respect to R&D budget changes, discontinuation of development candidates, and even M&A activity.
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Insights

CY2025 Medicare Advantage Proposed Rule

On November 6, 2023, CMS released its Contract Year 2025 Medicare Advantage and Part D Proposed Rule [CMS-4205-P]. ATI Advisory prepared a summary of key provisions and insights across D-SNP and dual eligible impacts, supplemental benefits, Part D formularies, network adequacy, agent and broker commissions, and equity-related provisions. The Rule has a heavy focus on beneficiary protections and program transparency.
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