2016 Marketing Guidelines: Evolve or Pay

Betsy Seals

There were several significant changes released in the 2016 Medicare Advantage & Part D Medicare Marketing Guidelines (MMGs), all of which communicate the same consistent message from the Centers for Medicare & Medicaid Services (CMS), the focus is on the beneficiary.

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MLTSS: Key to Caring for Duals

Mayling Naputi

We all want to do it: Provide the best healthcare services for our members. For our vulnerable population, …

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EHR Incentive Programs: Improving Access to Care

Mayling Naputi

The 2014 Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs were developed to provide financial incentives to …

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At the Intersection of Exhausted and Impossible

Debra Devereaux

Today, most employees and employers in all organizations struggle to do more with less…not just health plans.

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Quality Ratings: No National Standard for MCOs…Yet

Sunmi Janicek

A recent article noted five major changes in new Medicaid Managed Care rules, one pertaining to a quality …

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Obamacare Reinsurance and Risk Adjustment, Year One.

Jessica Smith

The much-anticipated “Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2014 Benefit Year” …

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Quick Hits for September Sweeps

Daniel Weinrieb

Unfortunately, Risk Adjustment does not have the luxury of taking the summer off. As CMS continues to stress …

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