The Battle For Medicare Advantage Star Ratings: SCAN and Elevance Victories Provide a Roadmap for Plans to Challenge CMS Methodologies

The Battle For Medicare Advantage Star Ratings: SCAN and Elevance Victories Provide a Roadmap for Plans to Challenge CMS Methodologies

By Charles Baker, VP, Compliance Solutions In the world of Medicare Advantage, the calculation of Star Ratings is more than a measure of quality – it’s a pivotal marker that can significantly sway federal funding and market competitiveness. Against the backdrop of high financial stakes and rigorous

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The Aftermath of the Change Healthcare Cyberattack: A Call to Action for Health Plans

The Aftermath of the Change Healthcare Cyberattack: A Call to Action for Health Plans

Charles Baker, VP, Compliance Solutions The recent cyberattack on Change Healthcare affected clinical-decision support, eligibility verifications, chart abstractions, and pharmacy operations, and has highlighted vulnerabilities within the industry’s digital infrastructure. In light of these disruptions, plans need to explore the broader implications, particularly concerning Part D, CAHPS,

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RADAR on Medicare Advantage | Medicare Advantage Experts Point to Member Experience, Provider Contracting as Worthy Investments

RADAR on Medicare Advantage | Medicare Advantage Experts Point to Member Experience, Provider Contracting as Worthy Investments

Reprinted with AIS Health permission from the 2/1/24 issue of Radar on Medicare Advantage 2024 Medicare Advantage Trends For our annual series of outlook stories on the year ahead in Medicare Advantage, AIS Health, a division of MMIT, asked multiple experts what they view as MA organizations’ “keys

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