Stand Tall Amongst Competition: Key to Success in Medicaid is Clear

Mayling Naputi

Health plans diligently strive to be the best and first choice for delivering excellent healthcare services.  Many seek accreditation with various organizations such as the National Committee for Quality Assurance (NCQA), the Utilization Review Accreditation Commission (URAC), and, most recently, the Malcolm Baldrige National Quality Award (MBNQA) as confirmation they provide their members with the utmost quality healthcare services.

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The $64,000 Question in Star Ratings

Melissa Smith

As we wrap up the 2nd quarter, health plan leaders across the country are beginning to ask their …

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CMS 2015 Spring Conference

Regan Pennypacker

Some important points came out of the Centers for Medicare & Medicaid Services’ (CMS’) Medicare Advantage Prescription Drug …

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The Imminent Medicaid Mega-Reg is Gonna be “Epic”

John Gorman

For the last several weeks health policy nerds have been anxiously awaiting the release of the long-awaited Medicaid managed …

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You’re Doing it Wrong in Care Management

John Gorman

An important paper recently released in the American Journal of Managed Care shattered the notion that care management …

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Five Critical Steps to Enhance Revenue & Maximize Growth Potential

Glenn Ellerbe

Everybody’s talking about revenue management and maximizing growth opportunities for health plans, but no one has laid out …

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19 Lessons from 19 Years

John Gorman

Nineteen years ago this week, I left the Health Care Financing Administration (HCFA), now the Centers for Medicare & …

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