Industry News
Preventing RADV Audit Exposure Through Compliant Risk Documentation Processes
Pareto Intelligence
4/22/2020
Operating a revenue management program in the Medicare Advantage (MA), Affordable Care Act (ACA) and/or Medicaid markets requires a concerted focus and effort on achieving complete, accurate and compliant risk documentation and scores. That third component—compliance—is often overlooked by health plans, at least until faced with a Risk Adjustment Data Validation (RADV) audit.
The Promise and Peril of Antibody Testing for COVID-19
JAMA
4/21/2020 1:20:00 PM
Serologic antibody tests not only can confirm suspected cases after the fact, they can also reveal who was infected and didn’t know it. Up to a quarter of people with SARS-CoV-2 infection may unwittingly spread the virus because they have mild or no symptoms.
CMS NEWS ALERT APRIL 14, 2020
Centers for Medicare and Medicaid Services
4/14/2020
Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation; Updated Medicaid & CHIP FAQs on Enhanced Federal Funding, Recent Congressional Action; CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic; 2019 Novel Coronavirus (COVID-19) Long-Term Care Facility Transfer Scenarios
CMS NEWS ALERT APRIL 13, 2020
Centers for Medicare and Medicaid Services
4/13/2020
Trump Administration Acts to Ensure U.S. Healthcare Facilities Can Maximize Frontline Workforces to Confront COVID-19 Crisis, Expanded Coverage for Essential Diagnostic Services, Removal of Non-Invasive Ventilator Product Category from DMEPOS Competitive Bidding Program, Applicability of Diagnoses from Telehealth Services for Risk Adjustment in Medicare Advantage, Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic
Why insurers need to keep up with Amazon and Google to succeed in Medicare Advantage
FierceHealthcare
2/11/2020
As MA enrollment increases—competition will too as insurers roll out more and more MA plans. One way your plan can stay competitive: develop a 360 degree view of your members using a CX platform. Join the Health Plan Alliance mini-workshop on this topic led by the author of this article, Mark Nathan, taking place at the Alliance Data and Infrastructure Evolution Summit, March 3-6 in Dallas, Texas.
Medecision CEO Named a Woman to Watch in Health IT by Becker’s Hospital
2/4/2020
Medecision are incredibly proud to announce that CEO Deborah Gage has been named to the list of Women to Watch in Health IT by Becker’s Hospital Review.
A Proactive Approach to Consumer Engagement
Aerial by Medecision
2/4/2020
At Medecision, we believe in a liberated healthcare system where people, plans and care teams engage in driving the best health outcomes in a seamless, interconnected way. The company helps our clients -- more than 85 leading US health plans and systems -- achieve this purpose by providing Aerial™, an integrated health solution with a suite of engagement and workflow solutions, and professional services through our Aveus division.
Understanding At-Risk Populations: Treating the Whole Person
Aerial by Medecision
2/4/2020
Aerial by Medicision know that high-risk populations often have complicated chronic diseases and behavioral health conditions, and social issues such as employment, food insecurity, lack of transportation and education can have a negative impact on health. What can the healthcare industry do to get to the root causes of these issues?
Beyond the Wow Factor: Getting the Most Out of Disruptive Technologie
Aerial by Medecision
2/4/2020
Learn through Aerial by Medecision how your organization can get ready to handle the change as technological innovations continue to flood the market. Will healthcare organizations adopt them at a pace that results in big-bang disruption or will they simply stick to the more measured approach that has historically been so common in the industry?
Enhancing Governance to Foster Innovation
American Hospital Association
1/30/2020
Eight ways that boards can embrace innovation and transformation so their organizations can plan for sector change.
Anthem Accelerates ‘Digital First’ Push with Key Hires, AI Investments
Health Payer Specialist
12/4/2019
Anthem, one of the nation’s largest health payers, has heavily loaded up on tech-savvy staff to ensure the company’s future, the online publication and venture capital incubator Vator reports.
Considerations in Driving Account Profitability
Front Edge
10/8/2019
What keeps you up at night? If your answer is how to improve your client driven bottom-line profitability - keep reading!
$100k Hearst Health Prize for Excellence in Population Health Submissions Now Open
HIT Consultant
5/20/2019
This week, Hearst Health announced that submissions are open for the 2020 Hearst Health Prize, an annual award in its 5th year that recognizes outstanding achievement of organizations managing or improving population health in the United States.
Commercial Health Plan Customer Satisfaction Challenged by New Era of Empowered Healthcare Consumers
J.D. Power
5/14/2019
Customer satisfaction among commercial health plan members has improved nationwide, but health insurers are still confronting challenges when it comes to delivering on the financial and personal health expectations of their members.
Seven Networking Tips for Health Execs
Managed Healthcare Executive
1/8/2019
Executive-level decisions can be complicated. Here are seven ways to turn to others to gain valuable insight.