Medicare Special Needs Plan sign-ups exceeded expectations from CMS during the 2025 annual enrollment period, offering a welcome boost to an otherwise slowing Medicare Advantage market. These products are a key to growth for Medicare Advantage, even though the rate of...

Unfulfilled home health referrals lead to higher mortality among Medicare Advantage (MA) members, according to a report published in the American Journal of Managed Care. The report documents 2,115 discharged patients who received home health services and 761...

Many families and seniors are desperate for alternatives to nursing homes. By 2030, one in five Americans will be over age 65, and most older adults say they would prefer to live in their homes for as long as possible. The Program for All-Inclusive Care for the...

It seems the only constant in Medicare Advantage (MA) and other government-sponsored programs is change, and this year was no exception.  MA is entering its third decade facing challenges like funding cuts and changing reimbursement models. To succeed, many health...

HLTH lived up to its “Be Bold” theme this year  and the show continues to cement its position as a unique, fun place for all stakeholders to gather, connect and advance their causes. The Dina team shares their takeaways from their time in Las Vegas. Notable this year...

In-home services have been shown to address social determinants of health and health equity. But finding capacity and arranging services for members remains a problem. “It is always difficult to find the right provider at the right time to meet the specific needs of...

Providing care and services to people following a hospital stay or during an extended illness is critical. But timely access to home-based care remains a massive problem. For health plans and providers, the process often involves intricate workflows, multiple...

The rapid growth of our aging population is reshaping how we think about administering long-term care in the home. But accessing in-home services remains a massive problem. Persistent workforce shortages and rising care costs present hurdles. And new mandates from CMS...

Forward looking health plans are leveraging supplemental and home-based benefits as an integral part of their value-based care strategies and programs. Many are offering preventative interventions including ADL support through homemaker and home health aide services,...

Most Medicare Advantage (MA) plans use the extra benefits they offer to attract new members and differentiate themselves from Medicare. That's nothing new.  What is new is increasing pressure from CMS to deliver those benefits in a high-quality, low-cost manner.  But...

Demand for behavioral healthcare services has skyrocketed, reflecting a growing recognition of the importance of mental health. However, access to these essential services remains a challenge.  Behavioral health conditions affect people of all ages: About one in five...

Dina has named healthcare veteran Sherman Sanchez as its new president. In this role, Sanchez will collaborate with the executive team to steer the company's continued growth and innovation strategy. Sanchez brings a 20-year track record of high growth and...

The “Ensuring Access to Medicaid Services'' rule has been finalized and the “80-20” provision has gone through as proposed. This means providers will eventually need to direct 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages. ...

Higher medical spending could be the new normal for the future of Medicare Advantage plans — and insurers will have to find a way to respond, according to a recent McKinsey report.  Some MA payers reported higher-than-expected inpatient and outpatient care utilization...

Non-medical supplemental benefits like personal care, meal delivery and home modifications have become important to health plans as a way to meet member’s needs and differentiate themselves from Medicare and their competitors. But they often struggle to operationalize...

CMS has signaled a renewed commitment to health equity with the introduction of the Health Equity Index (HEI), designed to motivate Medicare Advantage (MA) plans to identify and address disparities in care to members with social risk factors such as dual-eligibility,...

First Analysis Managing Director Andrew Walsh is a longtime healthcare executive and entrepreneur, who has worked with organizations like Optum, UnitedHealth Group and DaVita Health. He founded and scaled Educerus Health Solutions (acquired by PopHealthCare), an...

CMS released its much-anticipated 2024 Medicare Advantage final rule and Part D, which go into effect in 2025, codifying many of the provisions it proposed in the fall. We highlight six changes that will impact general enrollment MA plans, supplemental benefits...