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MVP Health Care, University of Vermont Health Network to co-create MA plan focused on elder care


(Photo by Westend61/Getty Images)
Nonprofit MVP Health Care, a health plan based in Vermont and New York, and the University of Vermont Health Network are teaming up to launch a joint Medicare Advantage plan, the organizations announced this week.
The entities are currently focused on adhering to regulatory requirements, and because of that offered few details about the benefit design. But a tentative start date has been announced: January 1, 2022.
MVP and UVM plan to announce further details of their Medicare Advantage insurance plan during this fall s annual enrollment period.
WHAT S THE IMPACT?
Medicare Advantage plans can offer coverage for services that original Medicare does not, such as vision, hearing, dental and wellbeing benefits. These plans are rapidly growing in popularity, with enrollment in Medicare Advantage doubling over the past decade, according to the Kaiser Family Foundation. ....

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Lee Russ: Don't understand Vermont's 'All Payer' health care reform? Welcome to the club.


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OneCare, Vermont’s “Accountable Care Organization” (ACO), operates the “All Payer” (AP) system that Vermont adopted a few years ago. It is frequently in the news these days, but even people who are heavily involved in health care issues don’t fully understand what it is, how it works, and why it supposedly benefits the people of the state. Someone who understands health care pretty well recently described the AP system as an impenetrable “black box.” [For background, you can check out the Green Mountain Care Board’s “frequently asked questions” about it: https://vtdigger.org/press release/frequently-asked-questions-vermont-all-payer-model-and-gmcb-aco-oversight/] ....

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Surprise Billing in the Consolidated Appropriations Act, 2021


Wednesday, January 27, 2021
Introduction
Surprise billing describes a situation when an insured patient unknowingly receives care from an out-of-network provider and then is presented with a bill for services and payment obligation beyond what the patient’s insurer will cover. Surprise medical bills can arise in an emergency when the patient has no ability to select the facility or provider rendering services. Surprise bills can also arise when a patient receives planned care, such as when a patient receives care at an in-network facility but later finds out that a provider who treated the patient is out-of-network. This most often happens with providers with whom the patient does not interact prior to the service, such as pathologists and radiologists. ....

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