by Jon Rogers, Sr. Consultant, Risk Adjustment As we reach the midpoint of 2024, managed care organizations (MCOs) must take a close look at their In-Home Health Assessment (IHHA) programs, which play a critical role in managing the health of Medicare Advantage and Affordable Care Act populations.
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Charles Baker, VP, Compliance Solutions and Tammy Hall, Senior Consultant, Compliance Solutions Medicare Advantage (MA) plans offering supplemental benefits have reported enrollee underutilization of many of these benefits. Supplemental benefits may include hearing, dental, vision, fitness programs, over-the-counter drugs, transportation for medical appointments, and other services that address
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– 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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– Charles Baker, VP, Compliance Solutions The transition of Medicare-Medicaid Plans (MMPs) to Dual-Eligible Special Needs Plans (D-SNPs) by the end of 2025 marks a significant change in healthcare delivery. This shift demands a comprehensive approach due to the complex regulatory ecosystem; it’s essential for health plans to
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment The CDC defines Health Equity as the state in which everyone has a fair and just opportunity to attain their highest level of health. Despite progress, health disparities remain a
Read More →Highlights from HCCA 2023 Managed Care Compliance Conference Presentation by Anne Crawford, ATTAC Consulting Group | Sandra J. Durkin, Strategic Health Law Click here to see full presentation
Read More →The CDC released ICD-10 code changes that go into effect April 1, 2023. All of the code changes are related to improving the capture of Social Determinants of Health (SDOH) information. There are 42 code changes aimed at improved specificity when documenting SDOH conditions, including classifications of:
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