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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2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

2025 Medicare Advantage Reforms: A Comprehensive Shift Towards Equity, Transparency and Patient-centered Care

Charles Baker, VP, Compliance Solutions The Centers for Medicare & Medicaid Services (CMS) continues to build upon its strategy to support person-centered, value-based care through the 2025 Medicare Advantage and Part D programs proposed rule. These proposals, a bold stride towards enhancing health equity, transparency, and patient-centric

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[Webinar Replay] How Providers and Health Plans Can Collaborate to Maximize Revenue and Quality

[Webinar Replay] How Providers and Health Plans Can Collaborate to Maximize Revenue and Quality

In this webinar, we discuss the critical role providers play in the success of improved health outcomes, Star ratings, HEDIS measures and risk adjustment. We dive into: – What provider organizations should know about the latest trends in Star ratings, HEDIS measures and risk adjustment – Risk

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Guarding Medicare’s Future: 2025 Proposed Rule to Revolutionize Medicare Advantage Agent and Broker Compensation

Guarding Medicare’s Future: 2025 Proposed Rule to Revolutionize Medicare Advantage Agent and Broker Compensation

Charles Baker, VP, Compliance Solutions The issue of Medicare Advantage (MA) plans paying administrative fees to field marketing organizations (FMOs) and agents is a hot topic. This is particularly true in light of recent congressional oversight hearings and the newly released 2025 Medicare Advantage Part D proposed

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Navigating the Changing Landscape of Mental Health Parity Compliance: Why Plans Need to Get Ahead of Proposed Rules and Implications

Navigating the Changing Landscape of Mental Health Parity Compliance: Why Plans Need to Get Ahead of Proposed Rules and Implications

Health plans and issuers need to ramp up compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) in response to the new proposed rules from the Departments of Labor, Health and Human Services. The proposed rules represent a significant shift in compliance measures, and plans

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Navigating Star Ratings in the Aftermath of CMS Plan Preview 2: Actionable Steps for Medicare Advantage Plans in 2023 and Beyond

Navigating Star Ratings in the Aftermath of CMS Plan Preview 2: Actionable Steps for Medicare Advantage Plans in 2023 and Beyond

Charles Baker, VP, Compliance Solutions The recent CMS Plan Preview 2 brought a collective gasp across the Medicare Advantage world. With many healthcare plans still celebrating high Star Ratings from 2022 and 2023, CMS applying the Tukey Method of analysis that resulted in adjusted cut points felt

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