The 2015 Ratings are In: Have the Stars Aligned?

Melissa Smith

The Centers for Medicare & Medicaid Services (CMS) has released the 2015 Medicare Advantage Star Ratings, and the Stars seem to be aligning with CMS’ goals of the Star Ratings program.  For the 40% of Medicare Advantage plans earning at least 4 Stars this year, and thus qualifying for Quality Bonus Payments, these newly-released Star Ratings illustrate the value of health plans’ investments in clinical innovation and quality improvement within Medicare Advantage product offerings.

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Part D Rejected Claims Continue to be Important Monitoring for CMS

Wayne Miller

Rejected claim analysis is a year-round activity with special emphasis that should begin before January. Are you confident …

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Marketplaces – Your Stars are coming

Steve Balcerzak

The Centers for Medicare & Medicaid Services (CMS) has been aggressively working in the background to establish the …

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High Value Network: Generation 4.0

John Nimsky

When it comes to healthcare, two truism’s are that medical costs are going up along with demand for …

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Does your current Model of Care coincide with the new requirements?

Peg Novak

The Centers for Medicare and Medicaid Services (CMS) revised the Model of Care (MOC) requirements, reducing core clinical …

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Reasonableness – The Last Chance

Steve Balcerzak

After four tries, some Marketplace health plan applicants have still failed to meet CMS reasonableness standards for 2015. …

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It’s a Marathon – Not a Sprint

Debra Devereaux

Plans will shortly be receiving the Readiness Checklist from CMS. At first glance it looks like just a …

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