Karen Elliott

Did you know that over half of all eligible Medicare beneficiaries are now enrolled in Medicare Advantage, and between 2018 and 2022 total MA-EGWP enrollment increased by nearly 27%? As health care costs continue to climb, public sector purchasers increasingly turn to MA-EGWPs to maintain or enhance coverage while reducing immediate costs and long term liabilities. Read more https://lnkd.in/dibKkCgA from the National Policy Institute for Public Employee Health Care Policy's Report underscoring the significant role MA-EGWPs play in retiree benefits.

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If you’re an employer who’s worked through increasing Kaiser costs (or you’re a Kaiser member doing so as well), you may find this article enlightening. Note: While it’s possible that “patient acuity” might be construed to refer to a patient’s mental sharpness, or lack thereof(!), here it refers to the severity of one’s medical condition and the level of care needed. #pharmacycosts #patientacuity #healthcareutilization #employeebenefits

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Turn to page 62 to learn more about precision medicine, why it is vital in healthcare and why everyone does not have access to this...proactive, precise, and personal, this is what we need!

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The Medical World is constantly evolving, impacting how we access care and the frequency of recommended screenings. "In the Loop" explores the recent changes, by the U.S. Preventative Services Task Force, in Breast Cancer Screening recommendations and sheds light on the rationale behind these updates. Additionally, the article delves into valuable insights on Ozempic. Stay informed with the latest developments in healthcare. #HealthcareUpdates #employeebenefits

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Carisk Partners latest webinar focuses on the management of Traumatic Brain injuries. See below to register

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When virtual healthcare is done right, third party validation should be the goal! It's time we held virtual healthcare providers to a higher standard! 😤 Don't just check the box, redesign it! 🩺 #virtualcare #healthcare #benefits #employers

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As Bob Dylan famously sang, "The Times They Are A-Changin'." Indeed, we're facing some possible changes to Medicare Advantage that could impact us all. It’s important to stay informed and prepared as we navigate these shifts. By understanding what's on the horizon, we can continue to provide the best service and advice to our clients. But amidst all these changes, there’s one thing that remains steadfast and reliable: Hospital Indemnity! It’s the perfect complement to any Medicare plan, offering additional peace of mind and financial protection. Hospital Indemnity is a true constant in an ever-evolving landscape, and it continues to be a "win-win" for both agents and clients. Now is the time to leverage the stability of Hospital Indemnity to make a real difference. By educating our clients on its benefits, we not only enhance their coverage but also reinforce our role as trusted advisors. This product bridges the gap between Medicare Advantage and Supplement plans, ensuring comprehensive protection for our clients. Let’s embrace the opportunity to make a positive impact. Get out there, share your knowledge, and start selling! Every conversation you have is a chance to make someone’s life a little easier and a lot more secure. Together, we can navigate these changes and come out stronger on the other side. Remember, success is not just about numbers; it’s about the lives we touch and the peace of mind we provide. So, let's all be winners! Stay positive, stay motivated, and let’s make a difference in the lives of our clients. #Medicare #Motivation #StayPositive #ClientCare

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Healthcare consolidation continues to reshape the industry landscape. Balancing the benefits of consolidation with the need for healthy competition is crucial for a sustainable healthcare system that prioritizes patient outcomes. #Healthcare #Consolidation #GovernmentRegulation #PatientCare

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#ICYMI Researchers at the Elevance Health Public Policy Institute studied Medicare data to understand how beneficiaries’ use of #MedicareAdvantage supplemental benefits impacts healthcare utilization. The results found that the use of supplemental benefits is associated with an increased likelihood of receiving certain preventative healthcare screenings, and a decreased likelihood of having an inpatient admission, among other findings. Check out the full report to learn more! https://ow.ly/GTJ830sCLGh

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Check out this recent article highlighting how Accredo is transforming the specialty pharmacy experience through improved processes.

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2025 sweeping changes to part D coverage is easily the most confusing for Medicare Advantage members. What a great opportunity for agents to provide much-needed education and guidance to your clients. One topic in particular that is causing confusion is the new Medicare Prescription Payment Plan. To help Priority Health members, we developed an easy-to-understand information page which includes a link for members to enroll. Use the link below to learn more and be sure to pass it on to your Priority health clients. https://lnkd.in/ePK84hEk This can be a great option for some members to ensure they have access to their prescription medications. We know agents are super busy this AEP. Our customer service team is educated and ready to help members with questions about the M3P and all part D changes. Don't hesitate to send them to our award-winning team! https://lnkd.in/eMnk44hi

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Medicare open enrollment – also known as the annual election period (AEP) or annual coordinated election period – refers to an enrollment window that takes place each fall, during which Medicare plan enrollees can reevaluate their existing Medicare coverage — whether it’s Original Medicare with supplemental drug coverage, or Medicare Advantage. Have questions lets talk: 949-741-1762

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Health Plans Need to Take Control! We received this impactful quote from a major TPA while investigating why specific claims are paid egregiously out of line with expectations. This proves why health plans need to improve this shell game and what is leading to medical spend waste in the US! "We can verify if the claim was paid correctly, including confirmation that the reprice amount provided by XXX (parent company) is correct. Outside of that, YYY (TPA) does not negotiate provider contracts nor has no influence on those contracts. Assuming most or all claims are processed correctly, what is your expectation once we have verified if claims have paid correctly based on what we have to work with? Provider contracts are complex and there could be items at play outside of simple fee schedules. XXX (parent company) provider contracts are considered proprietary, even to us as the TPA."

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📢 CMS Update: Recalculated 2024 Star Ratings Data Available to Public 📢 The CMS updated 2024 Star Ratings are now available in HPMS. Check out the updated Part C and D Star Ratings online. Once Medicare Plan Finder is updated, MA Plans are able to update any communication materials to show the updated ratings. 😁 Access the updated ratings here:    https://lnkd.in/et_wURVc #Medicare #StarRatings #Healthcare #CMSUpdate #HealthPlans

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IT'S DRIP THE HIP TIME!!! Medicare Advantage is changing fast for 2025, and your clients may face reduced options, higher out-of-pocket costs, and fewer supplemental benefits. Here’s what you need to know: #MedicareAdvantage #HospitalIndemnity #FutureProof #DriptheHIP

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