INTRODUCTION Driven by the moral imperative to address health disparities and objectives to improve health outcomes, many healthcare organizations have committed to achieving health equity. However, to create sustainable change, organizations must prove the return on investment (ROI) to build…

Introduction The recent publication of 2024 Medicare Advantage (MA) Star ratings confirmed that the regulatory and operating environment for this program will challenge health plans (especially compared to past years) as the Centers for Medicare and Medicaid Services (CMS) shifts…

As Medicare Advantage Organizations (MAOs) get ready for the upcoming Annual Enrollment Period (AEP), they should proactively prepare for one of the most competitive marketing seasons to date. The cumulative impact from changes in payment rates; regulatory pressure on Third…

Health plans are undergoing a transformation as they evolve their capabilities and business models to not only use data in new and innovative ways, but also cope with the increasing volume, variety and velocity of data. Given the impact COVID-19…