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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Harnessing the Power of Data: Integrating HEDIS, Risk Adjustment and Social Determinants of Health for Effective Population Health

Harnessing the Power of Data: Integrating HEDIS, Risk Adjustment and Social Determinants of Health for Effective Population Health

– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment  Leading healthcare organizations are developing strategies to align their programs and streamline the process of gathering crucial data to better serve beneficiaries. With the goal of achieving population health, managed

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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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Changes to Medicare Advantage Network Adequacy Requirements for Behavioral Health Services: What You Need to Know

– by Jocelyn Bayliss, Program Lead, Provider Network Management & Tina Gallagher, Market Manager, Provider Network Management In April 2023, CMS issued a final rule that added two new specialty types, clinical psychology and clinical social work, to network adequacy standards. Addition of Specialty Types and Amendments

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