John A. Anderson

How many times have you been asked for coverage options for a spouse who is not yet eligible for Medicare? Pivot Health offers a budget-friendly STM solution tailored to clients 60+ to bridge them to Medicare and features rich benefits including: ✔️ Easy and flexible enrollment (from 30 days to 12 months) ✔️ No network restrictions ✔️ Lower deductibles ✔️ Unlimited Dr. office visit copays and prescription drug discounts ✔️ Preventive and wellness exams ✔️ Annual OB-GYN exam and cancer screening ✔️ ER and hospitalization coverage ✔️ And more … Provide your clients with the flexibility and security they deserve. Watch our video to learn more about how this 12-month STM solution can benefit your clients, including Pre-Medicare. #healthcaresolutions #premedicare #pivothealth #insuranceagents #partners #budgetfriendly #continuouscoverage #shorttermmedical

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Blue Health Intelligence, a data analytics and software company, undertook an evaluation of almost 170,000 unique GLP-1 users for weight loss, notes less than half of those prescribed stay on the medication for 12 weeks or more. Younger adults were less likely to continue the drug, whereas those who were prescribed the medication by an endocrinologist or obesity medicine specialist were more likely to continue for longer. Indeed, this data states 30% of patients dropped out of treatment after the first four weeks, and 58% at 12 weeks. Those who dropped out are unlikely to achieve clinically meaningful weight loss.  The likelihood of continuance was further exacerbated for those with health inequities or who lived in underserved health regions. The data comes from Blue Cross Blue Shield Association members participating in Plans that provided coverage of these products, from 2014 through to end of 2023. Razia Hashmi, vice president for clinical affairs at Blue Cross Blue Shield wants to ‘…paint a clearer picture of what makes somebody successful.’ The missing piece here is why the patients stopped – side effects, failure to achieve initial weight loss, stigma and discrimination, or coverage issues related to cost and access. My longtime friend, colleague and bariatric surgeon at Stanford University, Dr. Dan Azagury rightly states ‘…The goal is for patients to stay on this for a significant amount of time. Most likely… beyond 12 weeks.’ https://lnkd.in/ediQskQx

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Is Medicare Advantage really working for seniors, or just making insurers richer? Medicare Advantage (MA) was introduced in 2003 to involve private insurance companies in Medicare with the promise of reducing costs and improving care for seniors. However, it has failed to achieve these goals. Instead, it has become a highly profitable system for private insurers, costing taxpayers billions each year. Private insurance companies exploit Medicare’s billing system through practices where they classify patients as sicker than they are to receive higher payments. Studies show that between 2007 and 2023, MA plans overcharged the federal government by $612 billion. In 2022 alone, taxpayers overpaid MA insurers by $88-$140 billion. These costs are projected to grow, with an additional $600 billion in excess spending expected by 2031. Despite these issues, Medicare Advantage continues to expand, driven by aggressive marketing campaigns and gaps in traditional Medicare coverage. Seniors are often drawn to MA plans with promises of lower costs and better benefits. However, many face denied claims, canceled plans, and limited access to care. For example, 80% of mental health providers in MA plans were found to be unreachable or out of network. Additionally, denial rates for care increased by 55.7% from 2022 to 2023. Meanwhile, insurers profit significantly from the system. In 2021, MA plans earned $1,730 in gross profit per beneficiary, more than double their margins on regular insurance plans. Some insurers, like Cigna, have faced legal action for submitting false diagnoses to increase payments. Rather than continuing to overpay private insurers, policymakers could strengthen traditional Medicare by redirecting these funds. This would ensure seniors receive better care and reduce unnecessary spending, creating a system that benefits patients rather than corporations. #MedicareAdvantage #MedicareReform #HealthcarePolicy #SeniorsCare #MedicareFacts #HealthInsurance #HealthcareCosts #SeniorHealth #HealthcareReform

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I always read Rock Health's digital health reports as they give a nice pulse feel for what is happening in the digital health funding space. Good to see funds raised in H1 2024 suggest funding in the sector seems to have stabilized at 2023 levels. Its no surprise the report emphasis the buzz around AI and healthcare. There have been clear winners in the AI healthcare space in the area of process and cost optimization and the R&D space. The impact of AI in care and treatment delivery is so far much more muted. One area I never though to look at AI was in its ability to bring together multiple healthcare pathways and digital point solutions into a more holistic seamless experience for the patient. There is a clear trend away from using stand alone digital health point solutions, and could AI address this challenge by facilitating the efficient integration of disparate processes and technology into unified care programs. I can see this happening with digital health products but this will be more tricky to do with physical care programs involving clinicians and HCPs. “AI is helping us combine multiple parts of the care journey, across all care experiences. In the future, benefits navigation, clinical guidance, and care delivery won’t be delivered by separate companies or point solutions within the healthcare ecosystem. They’ll be features that work in concert within products, and they’ll happen in under 90 seconds for a seamless patient experience.” – Glen Tullman, CEO, Transcarent and Managing Partner, 7wireVentures

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Planning for Medicare - Countdown to 65 Please join Medicare expert and Senior Plan Consultant at Blue Cross Blue Shield of Massachusetts, Susan Flanagan for this lively discussion about Medicare.  Topics Include: •  Medicare and Medicare Parts A and B •  Medicare enrollment timeline •  Medigap plans that supplement Medicare coverage •  Medicare Advantage plans, such as HMOs and PPOs •  Medicare Part D prescription drug plans •  Plans and programs available to early retirees, such as COBRA

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Just got done with a health insurance website and left feeling frustrated? You're not alone. A new study by J.D. Power found that member satisfaction with health plan websites is super low (think 565 on a 1000 point scale). That's worse than banks, mortgage companies, and even telehealth. What's the Problem? - Confusing Websites: Imagine a website where finding anything is like looking for a needle in a haystack. That's the reality for many health plan websites. - Unclear navigation and confusing layouts make it hard to find what you need. - Merger Mayhem: When health plans merge, their websites often become a jumbled mess. - Bad Forms: Filling out forms on a health plan website can feel like pulling teeth. Multiple clicks, missing info, and unclear instructions make it a frustrating experience. Learn how health plans can fix that experience: https://hubs.ly/Q02GzN6K0

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Just got done with a health insurance website and left feeling frustrated? You're not alone. A new study by J.D. Power found that member satisfaction with health plan websites is super low (think 565 on a 1000 point scale). That's worse than banks, mortgage companies, and even telehealth. What's the Problem? - Confusing Websites: Imagine a website where finding anything is like looking for a needle in a haystack. That's the reality for many health plan websites. - Unclear navigation and confusing layouts make it hard to find what you need. - Merger Mayhem: When health plans merge, their websites often become a jumbled mess. - Bad Forms: Filling out forms on a health plan website can feel like pulling teeth. Multiple clicks, missing info, and unclear instructions make it a frustrating experience. Learn how health plans can fix that experience: https://hubs.ly/Q02GzK_80

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Just got done with a health insurance website and left feeling frustrated? You're not alone. A new study by J.D. Power found that member satisfaction with health plan websites is super low (think 565 on a 1000 point scale). That's worse than banks, mortgage companies, and even telehealth. What's the Problem? - Confusing Websites: Imagine a website where finding anything is like looking for a needle in a haystack. That's the reality for many health plan websites. - Unclear navigation and confusing layouts make it hard to find what you need. - Merger Mayhem: When health plans merge, their websites often become a jumbled mess. - Bad Forms: Filling out forms on a health plan website can feel like pulling teeth. Multiple clicks, missing info, and unclear instructions make it a frustrating experience. Learn how health plans can fix that experience: https://hubs.ly/Q02GzN7H0

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How Much Money Can a Chiropractor Make? Believe it or not, the question of how much a chiropractor earns generates over 10,000 searches EACH MONTH on Google. In this article we looked at the current data and give our best estimates of how much a chiropractor can make based on the 4 most popular practice types: 1. Owning Your Practice 2. Becoming an Associate 3. Providing Chiropractic Coverage 4. Practice within a Larger Healthcare Organization Do you think we are pretty accurate? https://bit.ly/3Wpd99E

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Stop focusing on reactive care. Start proactive and preventative care. Actuvi's proactive approach to patient care uses data-driven insights to identify potential problems before they become emergencies. This means fewer hospitalizations, happier patients, and a more efficient practice.   A recent survey found that 64% of independent clinics have made digital care integral to their patient care strategy. Focus your limited time and energy on providing high-quality care with Actuvi - https://bit.ly/3Yu7S1q #digitalhealth #remotehealth #healthtech

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