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Article | October 21, 2021

Beneath High Ratings, MA-PD Stars Scores Show Shortcomings

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Reprinted with AIS Health permission from Oct. 21, 2021 issue of RADAR on Medicare Advantage. Thanks to numerous flexibilities granted to plan sponsors during the COVID-19 public health emergency, nearly 70% of Medicare Advantage Prescription Drug (MA-PD) plans earned an…

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Article | October 8, 2021

Will New Release of 4+ Star Plans Hasten the Depletion of the Medicare Hospital Insurance Trust Fund? Key Takeaways & Implications for Plans Coming Out of Recently Published 2022 Star Ratings

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Star Year 2022 Ratings have officially posted, allowing Medicare Advantage beneficiaries to compare plan options based on quality. This year, more beneficiaries will select from above-average plans, with 68% of MA-PDs (322 contracts) earning 4 stars or higher for Star…

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Article | September 8, 2021

Star Year 2022 Second Plan Preview: Everything You Need to Know

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Several changes have been made between the 2021 Star Ratings and the 2022 Star Ratings; below is a summary of key measure and methodological changes, as well as the impact they may have on your plan. Key Changes for Star…

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Article | August 6, 2021

What You Need to Know About CMS’​ Recent Flurry of MA Star Ratings Reports, Data and Notifications

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Yesterday evening CMS released a number of key documents for Star Year 2022 and 2023 including a last-minute announcement that the two, triple weighted HOS outcomes measures will be moved to the display page effective Star Year 2022 and 2023…

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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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