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

On June 13, 2024   /   Compliance, Star Ratings  
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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[Webinar Replay] How Providers and Health Plans Can Collaborate to Maximize Revenue and Quality

On December 8, 2023   /   Compliance, Medicare Advantage, Provider Network Management, Risk Adjustment, Star Ratings  
[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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Navigating Star Ratings in the Aftermath of CMS Plan Preview 2: Actionable Steps for Medicare Advantage Plans in 2023 and Beyond

On September 19, 2023   /   Compliance, Star Ratings  
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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