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Executive Briefing | December 16, 2020

Provider Data Management: A Longstanding Problem – Amplified in 2020 and Beyond

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YOUR PROVIDER DATA QUALITY PROBLEM MAY BE BIGGER THAN YOU THINK… AND IT COULD BE GETTING WORSE Under normal circumstances, inaccurate provider data presents significant operational and financial challenges for health plans. In 2020, these problems have been exacerbated across…

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Article | November 11, 2020

Healthcare Cost Transparency: The Guessing Game is Over

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In June 2019, the Trump administration issued an Executive Order (EO) that directed the U.S. Department of Health and Human Services (HHS) to propose regulations that enhance the ability for patients to shop for healthcare services. As directed by the…

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Article | June 22, 2020

MA Plans Test Digital Comms Tactics for Tech-Heavy AEP

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Reprinted with AIS Health permission from the May 21, 2020, issue of RADAR on Medicare Advantage. Despite the acceleration of U.S. COVID-19 cases in March — the third and final month of the Medicare Open Enrollment Period — switching rates among…

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Executive Briefing | January 21, 2020

2020 Healthcare Trends: The Year of Integration

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It’s that time of year again. At the start of every year, and particularly at the dawn of a new decade, the buzzing speculation of what is to come in the new year intensifies. In this Executive Brief, HealthScape has…

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Executive Briefing | November 13, 2018

Navigating CMS’ Enhanced Program Integrity—Preparing for the Spotlight

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On June 30th, CMS announced it was enhancing its Program Integrity efforts that focus on addressing improper Medicaid payments and CMS oversight of state Medicaid programs. The announcement introduced 8 initiatives, including stronger audit functions, enhanced oversight of state contracts…

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hfm Magazine | September 6, 2018

Integrated Revenue Cycle: Coordination Between Insurers and Providers to Ensure Revenue Accuracy

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Traditional revenue cycle management arrangements that focus solely on billing and collections are no longer reliable in the world of delegated risk models, especially for Medicare Advantage (MA) populations. That’s why Pareto recommends an innovative approach to managing value-based payments,…

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Executive Briefing | May 31, 2018

Is Change Good for the Medicare Advantage Market?

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With Medicare Advantage (MA) and Part D plans entering the final stretch for 2019 bid submission, each has undoubtedly spent a significant amount of time thinking about change. In April, CMS released the final policy and payment updates for these…

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