Podcasts about Medicare Advantage

A judge blocks recent changes to federal vaccine policy, a new report finds oversight could reduce Medicare Advantage overpayments, and a cyberattack disrupts Stryker's ordering system. These stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eseniorinsurance.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠✅ Call us: (801) 255-5340

Medicare Advantage cuts could hit seniors hard. Larry O’Connor speaks with Darren Grubb of Medicare Advantage Majority about CMS’s proposed 2027 rate increase, rising health care costs, Medicare funding, senior affordability, and what these changes could mean for premiums, deductibles, out-of-pocket costs, and access to doctors. This is a major warning for seniors, caregivers, and families counting on Medicare benefits. SHOP OUR MERCH: https://store.townhallmedia.com/ BUY A LARRY MUG: https://store.townhallmedia.com/products/larry-mug Watch LARRY with Larry O'Connor LIVE — Monday-Thursday at 12PM Eastern on YouTube, Facebook, & Rumble! Find LARRY with Larry O'Connor wherever you get your podcasts! SPOTIFY: https://open.spotify.com/show/7i8F7K4fqIDmqZSIHJNhMh?si=814ce2f8478944c0&nd=1&dlsi=e799ca22e81b456f APPLE: https://podcasts.apple.com/us/podcast/larry/id1730596733 Become a Townhall VIP Member today and use promo code LARRY for 50% off: https://townhall.com/subscribe?tpcc=poddescription https://townhall.com/ https://rumble.com/c/c-5769468 https://www.facebook.com/townhallcom/ https://www.instagram.com/townhallmedia/ https://twitter.com/townhallcomBecome a Townhall VIP member with promo code "LARRY": https://townhall.com/subscribeSee omnystudio.com/listener for privacy information.

A cyberattack tied to Iranian hackers hits a large medical device manufacturer. A new analysis links Medicare Advantage overpayments to higher premiums for seniors. And CVS Health partners with Google on a new consumer health engagement platform. That's coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Zeke Emanuel, Vice Provost for Global Initiatives at the Wharton School, joins the show to discuss recent reforms at the Centers for Medicare and Medicaid Services. The conversation covers site-neutral payments, strengthening primary care compensation, innovation models, and efforts to address waste and Medicare Advantage risk adjustment. They also examine the broader fiscal and policy implications for the $1.7 trillion agency. Hosted on Acast. See acast.com/privacy for more information.

MEDICARE ADVANTAGE MINUTE:                                                                      10% OF MEDICARE ADVANTAGE ENROLLEES WERE FORCED TO CHANGE PLANS FOR 2026! TWELVE STATES RACKED UP MORE THAN 20% MA DISPLACEMENTS. VERMONT WAS WORST WITH 90% OF MA ENROLLEES FORCED TO CHANGE PLANS. SPECIAL READING: CHAPTER 1 OF "MEDICARE ENROLLMENT GUIDE"! CHANGING JOBS AFTER 65? BE CAREFUL NOT TO BLOW UP MEDICARE! FINALLY, FIND OUT WHICH STATES ARE PROJECTED TO HAVE THE MOST NEW CANCER DIAGNOSES IN 2026! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2026; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE ENROLLMENT GUIDE!" (Free download from site below) "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

We've spoken with many guests about clinical and technological trends impacting healthcare providers, but less so about the trends on the business side of practicing medicine.  So on this episode, we're going to make up for that by spending our time with Dr. Alexander Vaccaro, an influential spine surgeon and president of one of the largest musculoskeletal practices in the U.S. -- Rothman Orthopaedic Institute -- which treats patients at over 40 locations in Pennsylvania, New Jersey, New York and Florida. While Dr. Vaccaro understands the desire for financial stability that's increasingly driving young physicians into the arms of hospital systems, he worries about what's being lost with the resulting decline in the number of independent practices.  “If you didn't have private practice advocating for the doctor, the insurance companies would bully the healthcare profession.” Join Raise the Line host Michael Carrese for a candid and lively conversation that also covers: How physician autonomy and entrepreneurship can drive innovation; The economic and policy forces reshaping private practice medicine; The role of research partnerships between private practices and universities. Mentioned in this episode:Rothman Orthopaedics If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Dawn Carter, senior director of health policy and regulatory affairs at  Centauri Health Solutions, joins RISE Radio for a lively discussion on the five skills health care leaders need to succeed in value-based care, starting with how to turn analytics into decisions that actually change outcomes. During this hour-long episode, Carter shares practical frameworks for working with data, regulations, interoperability, strategic storytelling, and social determinants of health.To learn more, see Carter in person at RISE National March 23-25 in Orlando where she will lead an interactive "Bingo" game roundtable discussion to uncover smarter strategies for risk adjustment. She'll also speak at the upcoming RISE webinar on interoperability that powers SDoH referral loop closure in value-based care on April 28 at 2 p.m. EDT.About Dawn CarterDawn Carter, BSBA, MHA, CPC, CRC, CPMA, CDEO, CPCO, AAPC Fellow, is the senior director of health policy and regulatory affairs at  Centauri Health Solutions, with over 30 years of experience in the health care industry. She has a proven track record of success in developing innovative products and services for the Medicare Advantage, Medicaid, and commercial health plan markets and is a sought-after industry speaker and author as well as independent consultant and educator.She holds a Bachelor of Science in Business Administration and a Master of Science in Healthcare Administration and is currently pursuing a Doctorate in Business Administration and Healthcare Management. She is a member of the American College of Healthcare Executives (ACHE) and is a Fellow of the American Academy of Professional Coders (AAPC). Her extensive AAPC certifications and recent appointment to the AAPC National Advisory Board for the 2025 -2027 term further demonstrate her deep commitment to knowledge and expertise in the health care field.About Centauri Health SolutionsCentauri delivers data-driven technology solutions that transform fragmented clinical and member data into actionable intelligence—maximizing accuracy, quality performance, and outcomes for health plans and health systems. Through close collaboration with our customers, Centauri improves patient and member outcomes by providing advocacy, advanced data insights, and intelligent clinical data delivery future-proofed for interoperability.

Thank you so much for listening to the Bob Harden Show, celebrating almost 15 years broadcasting on the internet. On Thursday's show, we discuss the consequences of the discord in the State legislature this Florida legislative session with the CEO of the Florida Citizens Alliance Keith Flaugh. We visit with Cato Institute Health Policy Studies Director Michael Cannon about the costs of Medicare Advantage programs that are passed on to the less healthy. We visit with CEI Senior Economist Ryan Young about the 250th anniversary of Adam Smith's “Wealth of Nations,” and we discuss economic data and interest rates. We also visit with the former Mayor of Naples Bill Barnett. We have terrific guests scheduled for Friday's show including the Leader of GW's Regulatory Studies Center William Yeatman and author and Professor Andrew Joppa. Access this and past shows at your convenience on my web site, social media platforms or podcast platforms.

In this episode, Krista Nelson, CEO of Optum Health, shares her vision for strengthening value based care through a more focused care delivery model, stronger clinician support, and expanded technology capabilities. She also discusses Medicare Advantage policy stability, the role of AI in reducing administrative burden, and how partnerships across the healthcare ecosystem can improve outcomes and patient experience.

The fallout from Trump's escalating conflict with Iran is growing, and the political backlash is getting louder. Polls show the war is deeply unpopular with Americans, with majorities disapproving of the strikes and questioning the administration's strategy. Even some prominent voices on the right are pushing back, warning that the conflict contradicts the “America First” promise to avoid new foreign wars. Meanwhile, a growing chorus online is asking whether this sudden military escalation is also serving as a distraction from the ongoing controversies surrounding Jeffrey Epstein and the unanswered questions many Americans still have. This episode is sponsored by MSI. Donate today Text LEMON to 511511, or https://MSIUnitedStates.org This episode is brought to you by BiOptimizers. Go to https://bioptimizers.com/donlemon and use my exclusive code DON15 to get 15% off any order. Make 2026 the year you finally start sleeping great again. This episode is sponsored by Graza. Take your food to the next level with Graza. Visit https://graza.co/LEMON and use promo code LEMON today for 20% off your first order! This episode is brought to you by Shopify. See less carts go abandoned and more sales go with Shopify and their Shop Pay button.Sign up for your one-dollar-per-month trial today at https://SHOPIFY.COM/lemon For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit megaphone.fm/adchoices

If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eseniorinsurance.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠✅ Call us: (801) 255-5340

In this episode of The Broker Link Podcast, Regional Sales Directors Cynthia Rosales and Leigha Hayes break down one of the most common questions agents face: Medicare Supplement vs. Medicare Advantage plans. The conversation begins with Original Medicare, which typically covers about 80% of approved medical costs, leaving beneficiaries responsible for the remaining 20%. Cynthia and Leigha explain how Medicare Supplement Plan G can help fill that gap by providing predictable coverage for many out-of-pocket expenses. They discuss guaranteed issue opportunities for Medicare Supplement plans, including when individuals turn 65 or transition off employer group coverage. While Plan G benefits are standardized across carriers, premiums can vary — with typical monthly costs for a 65-year-old female ranging between $100 and $200 depending on the carrier and location. The episode also explores Medicare Advantage plans, which often feature $0 premiums but require copays and cost-sharing when services are used. These plans may also bundle additional benefits such as prescription drug coverage, dental, vision, and hearing services. Cynthia and Leigha emphasize that both Medicare Supplement and Medicare Advantage plans include out-of-pocket maximum protections, helping beneficiaries manage financial risk while choosing the coverage option that best fits their healthcare needs and budget. Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com. Remember to like, share, and subscribe to our show!  New episodes are available every Tuesday. Join our Community! Linkedin: https://www.linkedin.com/company/the-brokerage-inc-/   Facebook:  https://www.facebook.com/thebrokerageinc/  Instagram:  https://www.instagram.com/thebrokerageinc/  YouTube:  https://www.youtube.com/@TheBrokerageIncTexas  Website:  https://thebrokerageinc.com/ 

Medicare is one of the most confusing parts of retirement planning. In this episode, Alex and Wade break down the basics, including the difference between Medicare Parts and Plans and the key choice retirees face between Original Medicare (Parts A, B, and usually D with a supplement) and Medicare Advantage (Part C). They discuss the tradeoffs between lower premiums and provider flexibility, how Medigap supplements like Plan G can reduce out-of-pocket costs, and why switching from Medicare Advantage to a supplement later may not always be possible. The conversation also touches on what Medicare does not cover and how retirees can estimate healthcare costs as part of their retirement plan. Listen now to learn more! Takeaways Most Americans become eligible for Medicare at age 65.  Retirees must choose between Original Medicare (Parts A, B, and usually D) or Medicare Advantage (Part C). Medigap supplements, such as Plan G, can help cover deductibles and coinsurance with Original Medicare. Original Medicare offers broader provider access, while Medicare Advantage often has lower premiums but network restrictions.  Switching from Medicare Advantage to a supplement later may require medical underwriting. Dental, vision, hearing, and long-term care are generally not fully covered by Medicare.  Retirees can compare options using Medicare.gov's Plan Finder or an independent broker.   Chapters 00:00 Introduction to Medicare and Health Care in Retirement 02:09 Understanding Medicare Parts A, B, C, and D 07:15 Medicare Supplements: Plans A through N 14:07 Comparing Medicare Advantage and Original Medicare 19:39 Navigating Medicare Enrollment and Budgeting for Health Care   Links

In this episode, Jennifer L. Kowalski, Vice President of the Public Policy Institute at Elevance Health, discusses how rigorous research and data shape Medicare Advantage strategy, from supplemental benefits to dual eligible integration. She shares insights on affordability, care navigation, and how evidence based policy can strengthen value, access, and long term sustainability in the program.

Broadcast from KSQD, Santa Cruz on 3-05-2026: Dr. Dawn demonstrates how to critically read a science paper using a widely-publicized study claiming adolescent cannabis use causes psychotic, bipolar, and anxiety disorders. She identifies multiple methodological problems: only 5.7% of Kaiser adolescents admitted cannabis use versus 11.2% in anonymous national surveys, suggesting massive underreporting; the study conflates any use with heavy use; and with 463,000 participants, trivially small differences become statistically significant but clinically meaningless. She proposes reverse causation—that prodromal schizophrenia symptoms may drive teens to self-medicate with cannabis rather than cannabis causing psychosis. The study also included "disruptive behavior disorder" diagnoses that lack rigorous criteria, and she notes diagnostic codes are sometimes chosen for insurance reimbursement rather than accuracy. While acknowledging high-dose THC before age 16 may affect brain development, she concludes the headlines claiming causation are not supported by the actual findings. Dr. Dawn discusses how aquaculture—now producing 60% of fish consumed globally—has become a breeding ground for antibiotic-resistant pathogens. More antibiotics per kilogram are used in fish farming than in any other animal agriculture, with drugs dissolving into water and sediment where bacteria develop resistance. One study found antibiotic-resistant bacteria in over 80% of shrimp species tested across multiple countries. Through horizontal gene transfer, these resistance genes spread to human pathogens—a 1991 Latin American cholera outbreak affecting nearly a million people may have acquired drug resistance from Ecuadorian shrimp farms. Dr. Dawn reports that the FDA rejected Moderna's mRNA flu vaccine application without even reviewing it, despite trials of 41,000 people showing it was 27% more effective at preventing illness and 29% more effective at preventing hospitalization than existing vaccines. She attributes this to politicized anti-mRNA bias lacking scientific basis, noting that venture capital investors like Blackstone (who invested $750 million) will now avoid vaccine development, effectively handing this critical technology to other countries. Dr. Dawn describes the "wellness industrial complex"—pharmaceuticals, tech, testing companies, and health influencers creating content that pathologizes normal behaviors. YouTube health videos have amassed 200 billion views, and 30% of British respondents now get medical advice from AI chatbots. She cites a 400% increase in British adults seeking ADHD diagnoses, noting that analysis of top TikTok ADHD videos found less than 50% accurately reflected actual symptoms. Many influencers receive undisclosed payments to mention products, and the U.S. and New Zealand are the only countries allowing direct-to-consumer drug advertising. A caller asks about navigating Medicare after their Advantage plan was terminated with no local providers accepting remaining plans. Dr. Dawn explains that Medicare Advantage companies took extra government payments meant for wellness programs but didn't build them, and are now exiting markets as costs rise. She recommends contacting Gray Bears or AARP for free Medicare navigation assistance and suggests exploring regular Medicare with a secondary plan or direct-pay practices. /li>

Talarico exposes billionaire power but misses capitalism's myths, Trump fires DHS chief Kristi Noem amid immigration chaos, and Democrats push legislation to expose Medicare Advantage profiteering.Subscribe to our Newsletter:https://politicsdoneright.com/newsletterPurchase our Books: As I See It: https://amzn.to/3XpvW5o How To Make AmericaUtopia: https://amzn.to/3VKVFnG It's Worth It: https://amzn.to/3VFByXP Lose Weight And BeFit Now: https://amzn.to/3xiQK3K Tribulations of anAfro-Latino Caribbean man: https://amzn.to/4c09rbE

Thank you Elizabeth Raven, Elwyn Hudson, PaulM, Cheryl Elkins

In this episode, Jakob Emerson, Associate News Director at Becker's Healthcare, breaks down the latest Medicare Advantage enrollment trends, including slowing overall growth, major gains for regional and system owned plans, and mounting federal scrutiny of large insurers. He explores what CMS actions, risk adjustment settlements, and market exits mean for payers, providers, and the future of the program.

We've had many conversations on Raise the Line about the challenges of health communication in today's world of information overload, but none of our guests have the kind of expertise Dr. Tesfa Alexander has acquired in a career that has taken him from Madison Avenue to the halls of government and academia. From guiding tobacco education research at the FDA to leading public health initiatives at MITRE, Dr. Alexander has developed a deep understanding of the science and strategy behind effective health communication. “Successful campaigns keep the long game in mind where you want to develop a lasting relationship with your target audience,” he tells host Lindsey Smith. That relationship needs to be built on understanding culture, beliefs, priorities and daily realities, and only then can you develop messaging that will resonate, he explains. Dr. Alexander also believes these relationships can be leveraged to help people sort out facts from misleading or inaccurate claims. “I strongly recommend shifting our focus from combating misinformation head on, and instead working with the communities who we are seeking to serve.” This fascinating look at communication science also covers: How stories drive belief; The importance of working with community partners who are trusted messengers;  The power of audience segmentation. Tune in as Dr. Alexander unpacks what it takes to influence beliefs, and ultimately behaviors, in an era defined by misinformation and institutional mistrust. Mentioned in this episode:Lerner Center for Public Health Advocacy If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Elevance Health's Medicare Advantage plans face federal sanctions. The University of Mississippi Medical Center clinics reopen after a ransomware attack. And the FDA warns telehealth companies about marketing compounded weight loss drugs. That's coming up on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this week's episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl unpack a wide range of developments shaping healthcare in America today, including the TrumpRx drug discount program. From new legislation affecting telehealth and pharmacy benefit managers (PBMs) to the rapid spread of measles and growing public concern about vaccine policy, this month's discussion highlights the policy decisions and scientific debates influencing medicine right now. The episode opens with the latest federal legislation passed to avert a government shutdown. While healthcare was not the central focus of this particular political battle, the bill contains several provisions that affect medical practice. These include extensions for telehealth coverage and hospital-at-home programs, reforms targeting PBM transparency and new requirements designed to address “ghost networks” in Medicare Advantage provider directories. Dr. Pearl explains that while these provisions represent incremental progress, they are unlikely to solve the larger problems driving healthcare costs and access challenges in the United States. Here are the other major storylines from episode 104: Healthcare costs remain nation's top concern: A new KFF poll finds that healthcare expenses rank above food, housing and utilities as the economic issue Americans worry about most. Prior authorization frustrations grow: Many patients report delays or denials of care due to insurance requirements, highlighting persistent tension between insurers, physicians and patients. Drug pricing debates continue: Pearl examines a new prescription drug website initiative and explains why it may have limited impact compared with broader policy proposals such as “most favored nation” pricing. Telehealth's uncertain future: Although the latest legislation extends certain pandemic-era flexibilities, the lack of a permanent solution leaves virtual care programs in limbo. PBM reforms move forward slowly: New policies aim to increase transparency and reduce incentives tied to drug list prices, though Pearl notes that meaningful change will depend on future implementation. Site-neutral payment gains attention: A provision requiring unique identifiers for outpatient services could pave the way for policies that eliminate higher reimbursement for hospital-owned facilities providing identical care. Measles outbreaks surge: Nearly a thousand cases have already been reported in 2026, with the overwhelming majority occurring among unvaccinated children. Trust in the CDC declines: Polling shows confidence in the agency has dropped significantly following changes to vaccine recommendations. Independent vaccine review groups emerge: Medical organizations and states are forming new committees to evaluate vaccine evidence as federal guidance becomes more contested. Early colon cancer deaths rise: The death of actor James Van Der Beek at age 48 highlights the growing incidence of colorectal cancer among younger adults and the importance of earlier screening. FDA confusion over a new flu vaccine: The agency initially declined to review Moderna's mRNA-based flu vaccine before reversing course and agreeing to evaluate it ahead of the next flu season. Younger Americans face worsening health trends: New claims data suggest chronic disease is appearing earlier among millennials and Gen Z, driven by lifestyle factors and reduced connection to primary care. Wearable data reveal health disparities: Apple Watch data show significant differences in resting heart rates across states, reflecting variations in lifestyle, access to care and public health conditions. As the episode concludes, Dr. Pearl warns that growing political conflict around vaccines and biomedical research risks undermining public trust in science. The consequences, he argues, could shape American medicine for decades to come. Tune in for more fact-based analysis and discussion of the biggest stories in healthcare. * * * Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn The post MTT #104: TrumpRx, rising measles cases & the politics of vaccine science appeared first on Fixing Healthcare.

Today, Don breaks down Day 2 of Kristi Noem's testimony, this time before the House, and let's just say… it was wild. From tense exchanges to repeated dodges, lawmakers pressed Noem hard on her leadership, policy decisions and accountability. Instead of clear answers, viewers saw deflection, contradiction, and mounting frustration from members of Congress on both sides of the aisle. What stood out? What questions did she refuse to answer? And after two days of heated hearings, will there be any real consequences, or is this just another Washington spectacle with no follow-through? This episode is brought to you by Incogni. Go to https://incogni.com/donlemon and use code donlemon for 60% off. Incogni HELPS wipe yourself from the Internet — they can't harm you if they can't find you. Click the link below to claim your 60% off and get your personal data off the market! Erase yourself from the internet. This episode is sponsored by 120Life. Go to https://incogni.com/donlemon and use code donlemon for 60% off. Incogni HELPS wipe yourself from the Internet — they can't harm you if they can't find you. Click the link below to claim your 60% off and get your personal data off the market! Erase yourself from the internet This episode is sponsored by BetterHelp. BetterHelp makes it easy to get matched online with a qualified therapist. Sign up and get 10% off at https://BetterHelp.com/donlemon This episode is brought to you by Shopify. See less carts go abandoned and more sales go with Shopify and their Shop Pay button.Sign up for your one-dollar-per-month trial today at https://SHOPIFY.COM/lemon For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit megaphone.fm/adchoices

This morning, Don breaks down the latest updates on the rapidly expanding crisis in the Middle East. As U.S. and Israeli strikes against Iran continue, regional retaliation spreads, and world powers grapple with what may be a long, costly conflict with no clear end in sight. We'll talk about how this is already affecting American lives, from rising fuel prices at the pump to economic ripple effects and global instability, and what might come next as tensions escalate day by day. Then, we'll shift gears to take a look at today's major political news from Texas: James Talarico has won the Democratic primary for the U.S. Senate race, emerging victorious over Congresswoman Jasmine Crockett in a closely watched contest that could reshape statewide politics this November. Can he flip a long-Republican seat in the general election? We'll break down what this win means and what lies ahead. This episode is brought to you by Incogni. Go to https://incogni.com/donlemon and use code donlemon for 60% off. Incogni HELPS wipe yourself from the Internet — they can't harm you if they can't find you. Click the link below to claim your 60% off and get your personal data off the market! Erase yourself from the internet. This episode is sponsored by 120Life. Go to https://incogni.com/donlemon and use code donlemon for 60% off. Incogni HELPS wipe yourself from the Internet — they can't harm you if they can't find you. Click the link below to claim your 60% off and get your personal data off the market! Erase yourself from the internet This episode is sponsored by BetterHelp. BetterHelp makes it easy to get matched online with a qualified therapist. Sign up and get 10% off at https://BetterHelp.com/donlemon This episode is brought to you by Shopify. See less carts go abandoned and more sales go with Shopify and their Shop Pay button.Sign up for your one-dollar-per-month trial today at https://SHOPIFY.COM/lemon For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit megaphone.fm/adchoices

If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eseniorinsurance.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠✅ Call us: (801) 255-5340

Managing a chronic condition on Medicare? In this episode, we explore how Medicare Advantage plans and Special Needs Plans (SNPs) work for individuals with ongoing health conditions, including the limitations and requirements that can affect your care. Discover why many people choose Medicare Supplement plans for greater freedom, broader doctor access, and fewer restrictions when managing their long-term health.

Trying to decide between Medicare Supplement and Medicare Advantage? In this episode, we walk you through the key differences and the most important questions to ask before enrolling. Learn how to evaluate costs, provider networks, coverage flexibility, and long-term stability so you can choose the Medicare option that best protects your health and retirement finances. 

Are you a veteran trying to choose between Medicare Supplement and Medicare Advantage? In this episode, we break down how each option works alongside your VA benefits. Discover how Medigap plans can offer nationwide doctor access, more predictable healthcare costs, and the freedom to seek care outside the VA system when you need it—giving you greater flexibility and peace of mind in retirement. 

Discover the peace of mind that comes with network-free healthcare. In this episode, we explain how Medicare Supplement plans give you the freedom to choose your doctors, specialists, and hospitals nationwide—without the restrictive networks, referrals, or prior authorizations common in many Medicare Advantage plans. Learn how this flexibility can help you maintain control over your healthcare and enjoy greater confidence in retirement. 

Want access to the best hospitals when it matters most? In this episode, we compare Medicare Supplement vs. Medicare Advantage and explain why many retirees choose Medigap plans for greater medical access, fewer restrictions, and more predictable healthcare costs. Learn how your Medicare choice can impact your ability to receive care at top hospitals and specialists nationwide. 

In this episode, Karen Walker Johnson, Chief Executive Officer of Clever Care Health Plan, discusses how culturally competent, value based care is reshaping Medicare Advantage. She shares insights on strengthening provider trust, investing in community based engagement, and advocating for quality metrics that recognize cultural competence to improve outcomes and affordability.

Medicare is a cornerstone of most retirement plans, but it's also a brand-new system for people who've spent decades on employer coverage. Melissa Joy, CFP® sits down with Cameron Giardini of to break down what Medicare is, when you actually need to enroll, and how to avoid the most common (and costly) mistakes.They cover the major coverage paths (Original Medicare + Medicare Advantage vs Medigap), why your first enrollment decision at 65 can affect your options later, and what higher earners need to know about IRMAA surcharges. Cameron also explains a key HSA pitfall, shares what's changing heading into 2026, and points listeners to free education resources to start learning without overwhelm.What You'll LearnWhat Medicare is (and isn't), and when it typically startsWhen to begin planning, and how to check eligibility and costsWhen you can delay Medicare past 65 without penaltiesThe key decision: Medicare Advantage vs Medigap (and what each really means)Why your first Part B enrollment window matters for lifetime flexibilityWhat IRMAA is, how it's calculated, and how to appeal it after retirementHow HSAs interact with Medicare and what not to do at 65What's getting more expensive in 2026 and why “choice” may continue shrinkingHow adult children can help parents by first identifying what coverage they actually haveConnect with Cameron: https://gmedicareteam.com/Youtube: www.youtube.com/@GiardiniMedicareThe previous presentation by PEARL PLANNING was intended for general information purposes only. No portion of the presentation serves as the receipt of, or as a substitute for, personalized investment advice from PEARL PLANNING or any other investment professional of your choosing. Different types of investments involve varying degrees of risk, and it should not be assumed that future performance of any specific investment or investment strategy, or any non-investment related or planning services, discussion or content, will be profitable, be suitable for your portfolio or individual situation, or prove successful. Neither PEARL PLANNING's investment adviser registration status, nor any amount of prior experience or success, should be construed that a certain level of results or satisfaction will be achieved if PEARL PLANNING is engaged, or continues to be engaged, to provide investment advisory services. PEARL PLANNING is neither a law firm nor accounting firm, and no portion of its services should be construed as legal or accounting advice. No portion of the video content should be construed by a client or prospective client as a guarantee that he/she will experience a certain level of results if PEARL PLANNING is engaged, or continues to be engaged, to provide investment advisory services. A copy of PEARL PLANNING's current written disclosure Brochure discussing our advisory services and fees is available upon request or at https:...

In this episode, Jennifer L. Kowalski, Vice President of the Public Policy Institute at Elevance Health, discusses how rigorous research and data shape Medicare Advantage strategy, from supplemental benefits to dual eligible integration. She shares insights on affordability, care navigation, and how evidence based policy can strengthen value, access, and long term sustainability in the program.

MEDICARE ADVANTAGE MINUTE:                                                                        MY DOCTOR DROPPED OUT OF MY (MA) NETWORK; WHAT SHOULD I DO NEXT? Q & A illustrates the limitations of Medicare Advantage plans. Article: Do Not Add to the Social Security Administration Delays In other words, do not make these errors that will delay the time between the start of your application and confirmation of the effective date of your Medicare coverage. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2026; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE ENROLLMENT GUIDE!" (Free download from site below) "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

In this episode, Karen Walker Johnson, Chief Executive Officer of Clever Care Health Plan, discusses how culturally competent, value based care is reshaping Medicare Advantage. She shares insights on strengthening provider trust, investing in community based engagement, and advocating for quality metrics that recognize cultural competence to improve outcomes and affordability.

MedPod Today: the podcast series where MedPage Today reporters share deeper insight into the week's biggest healthcare stories. This week, MedPage Today reporters discuss the revolving door leadership at NIH's Institutes and Centers, UnitedHealthcare's controversial new Medicare Advantage policy, and a bill that would erase two decades worth of certain types of state nursing board discipline. Episode produced and hosted by Rachael Robertson. Sound engineering by

In this episode, Jakob Emerson, Associate News Director at Becker's Healthcare, breaks down limited federal direction following the State of the Union, a potential drop in ACA exchange enrollment, Medicare Advantage surpassing 55 percent penetration, and how insurers and health systems are navigating a rapidly changing and increasingly strained payer landscape.

We're marking Rare Disease Month 2026 by highlighting the powerful story of Shanthi Hegde, a young patient advocate working to transform how bleeding disorders are understood, treated, and supported. This work is fueled by her own arduous journey with two rare bleeding disorders and immune dysregulatory syndrome, and an extended diagnostic odyssey marked by dismissal, underdiagnosis, and structural bias. “I was told many times by many providers that these disorders are not common in Indians and that my bruises were there just because I'm brown.” Admirably, Shanthi pushed past this mistreatment, advocated for her medical needs, and devoted herself to tackling a range of issues confronting rare disease patients from mental health access to affordable drug pricing to research equity. In this remarkable Year of the Zebra conversation with host Lindsey Smith, you'll also learn about: Shanti's work with the Hemophilia Federation of America; How gaps extend beyond treatment to include insurance coverage, provider training, and substance use care; What clinicians can do to improve the work they do with rare disease patients. Join us for a conversation that connects patient voice to system change, and explores what real equity for rare disease communities will require. Mentioned in this episode:Hemophilia Federation of AmericaShanthi's LinkedIn Profile If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eseniorinsurance.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠✅ Call us: (801) 255-5340

This year has been something of a reckoning for Medicare Advantage. Senator Grassley's scathing report of UHG's risk adjustment practices, and the Kaiser $556 million settlement to resolve False Claims Act allegations of upcoding, opened eyes, and got many in the industry talking. I wanted to get someone on the show with opinions, unafraid to speak their mind and share their perspective. I've found that person. Betty Stump is Senior Solution Consultant for Edifecs, a Cotiviti Business. She is in the business of risk adjustment and value-based care on the vendor side, but is never afraid to offer her opinion on the industry, pro and con. And with more than 20 years in the industry across multiple well-known companies, it's an informed one. Listen in as we discuss: What is working in value-based care/risk adjustment—and where have we gone wrong? Recent conference disillusionment. Kaiser DOJ fine and the Grassley report taking aim at UHG's aggressive risk adjustment strategy: Betty's thoughts and where does this heightened era of scrutiny put risk adjustment coders. Do we need to elevate the MEAT standard? What are organizations missing with risk adjustment? Great, practical, low-tech suggestions for RAF capture including using your 2025 end-of-year roster to identify those patients with high-risk conditions and engage in proactive outreach to get patients seen. V28 of CMS-HCCs with V24 in the rear-view mirror. Truthful tech talk: How leaders can get a seat at the table, how to get a vendor's ear to modify functionality, and truth and hype in CDI tech How should a CDI or coder interact with a machine prompt from a suspecting tool? Looking back at a colorful 20-year career in the consulting life, and a thoughtful selection for the Off the Record Spotify playlist by a fellow music enthusiast.

Prior authorizations among Medicare Advantage plans have drawn criticism and concern from patients, providers, lawmakers, and regulators. But hospitals and doctors are uniquely positioned to advocate for their patients' access to and coverage for care. What's necessary is the need to understand the rules of the process. And Medicare Advantage plans have many of them.During the next live edition of the venerable Monitor Monday, the Internet broadcast, Richelle Marting, a healthcare attorney, and certified coder, will help you understand when and how Medicare Advantage plans can use prior authorizations for the critical protections you need to know to advocate for patient care.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Matthew Albright of Zelis, will report on current healthcare legislation.

The Food and Drug Administration will review Moderna's new flu vaccine after reversing course. Medicare Advantage growth in 2026 is trailing prior years. And Amazon is expanding same-day prescription delivery to nearly 5,000 cities nationwide. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws. In this episode, Chris Van Gorder, President and Chief Executive Officer of Scripps Health, explains why health care is becoming structurally unaffordable amid soaring premiums, uncompensated emergency care, and rising input costs. He describes how hospitals have become the default safety net as county systems disappear, while underpayment by Medicare and Medicaid forces cost shifting onto employers and commercially insured patients. Van Gorder also highlights California's seismic rebuilding mandates, which create massive capital pressure without matching reimbursement. He critiques managed care, value-based care, and Medicare Advantage for pushing risk onto providers through prior authorization and denials, recounting Scripps' difficult decision to exit several Medicare Advantage contracts after heavy losses and the downstream impact on patients. Tune in and learn how payment design, intermediaries, and regulation shape what hospitals can sustain and what patients can access. Resources: Connect with and follow Chris Van Gorder on LinkedIn. Follow Scripps Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

The Non-Market Reality of Healthcare Carrier Marketplaces with Dr. Jacob Asher. In this episode of Relentlessly Seeking Value, host Stacey Richter introduces the 'No Market' series focused on the healthcare sector's lack of competitive market dynamics, which affects cost and quality.  The episode features a conversation with Dr. Jacob Asher, who has extensive experience as a Chief Medical Officer at major healthcare plans. They discuss the stagnant nature of commercial carrier marketplaces, particularly in California, and the various factors contributing to this stasis, including employer inertia, the influence of employee benefit consultants, and the strategic focus of carriers on Medicare Advantage over commercial business.  They also explore how carriers' dependence on existing provider networks and contractual negotiations based on member volumes contribute to a lack of meaningful competition. The episode highlights the challenges faced by plans attempting to innovate or differentiate on quality and the systemic issues that perpetuate the current equilibrium. === LINKS ===

Few issues have tested public trust in medicine as deeply as vaccines, and few individuals have influenced that dialogue more than Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a longtime member of the FDA's Vaccine Advisory Committee. In this timely and candid interview with Raise the Line host Lindsey Smith, Dr. Offit points to this year's severe flu season and a resurgence of measles as alarming proof points of how a changing federal perspective on vaccine policy is having a real impact on public health. “You'd like to think you can educate about the importance of vaccines, but I fear at this point the viruses themselves are doing the educating.” In this wide ranging discussion, Dr. Offit also addresses: The rigorous and painstaking process of developing vaccines, based on his experience co-inventing the rotavirus vaccine. Shifting levels of public trust in scientific organizations. Promising innovations in vaccine development. Don't miss this deeply-informed perspective on the interplay of science, policy, and public education, and his encouraging message to young clinicians about managing the current challenges in public health.  Mentioned in this episode: Vaccine Education Center at Children's Hospital of PhiladelphiaPerelman School of Medicine If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Legislation has played a defining role in how dialysis care is delivered in the United States, directly influencing access, coverage, and patient choice. In this episode of Kidney Commute: Pitstop, host Osama El Shamy, MD, FASN, FNKF, is joined by Lauren Drew, JD, and Eugene Lin, MD, MS, FASN for an in depth discussion on the policy decisions that have shaped kidney care. The conversation traces key legislative milestones, including the creation of the ESRD benefit, the Medicare dialysis bundle, Medicare Advantage expansion, and the Advancing American Kidney Health Initiative. Speakers also examine the current legislative landscape, its impact on dialysis patient choice, and opportunities for professional advocacy in kidney care.

If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eseniorinsurance.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠✅ Call us: (801) 255-5340

Once a high growth, high margin line of business for health plans, Medicare Advantage (MA) is now in the middle of a financial reset. Growth has slowed, margins have turned negative, and federal financial support is eroding — with CMS proposing a near flat reimbursement increase for 2027. As a result, plans are exiting markets, tightening benefit designs, and shifting their focus toward Special Needs Plans (SNPs). At the same time, seniors are facing rising costs, fewer perks, and more frequent plan changes. To cut through the noise and understand what's really happening beneath the headlines, host Rachel (Rae) Woods speaks with Advisory Board experts Sally Kim and Aaron Hill about the new divide emerging in MA: between plans equipped to manage the intensive needs of high cost seniors and execute on SNP strategies — and those that will be forced to exit markets or rethink their MA ambitions entirely. Listen as they break down how MA's financial and clinical headwinds are reshaping payer–provider relationships — and why future success depends on disciplined focus, deeper provider partnerships, and new investments in technology and cross benefit management. We're here to help: Tool | Medicare Market Explorer Webinar | Medicare Advantage: Insights on today's more competitive market Webinar | Medicare Advantage: The latest on product design and growth Podcast | Ep. 227: The changing tide of Medicare Advantage Expert Insight | 3 data-driven insights on Medicare Advantage Star Ratings Ready-to-Use Slides | Medicare Advantage market outlook 2026 Advisory Board Summit Washington, D.C. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In this episode, Alex Ding, MD, Enterprise Deputy Chief Medical Officer at Humana, discusses the findings from Humana's latest Value-Based Care Report, including lower hospital admissions and emergency department visits among Medicare Advantage members in value based arrangements. He shares how deeper primary care continuity, stronger payer provider alignment, and reduced administrative burden are key to scaling sustainable, outcomes driven care. Learn more here: https://humana.com/vbc