Medicare Advantage Toolkit

On June 29, 2018, CMS announced it was advancing its demonstration to waive MIPS requirements for clinicians in certain at-risk Medicare Advantage plans. This toolkit includes comments from Simon Moody at Milliman, Simon's recent presentation to Alliance members regarding MACRA and the QPP, and other valuable information on trends in MA, alternative payment models (APM) and MACRA.

Interested in learning more? Review all the presentations shared at the 2018 Co-located: Government Programs AND Risk, Compliance, Privacy and Security Value Visit.

NOTE: You must login to your Alliance account to access the articles and resources below. Some content may only be accessible to Alliance members.

 

11/19/2019

Medicare Advantage Audit Survivors: Health Plan Panel
A shared presentation from three health plans that have recently completed a CMS Medicare Advantage Program Audit. These Compliance and Operational experts share the audit experience from top to bottom, and lessons learned along the way. The archived presentation details how these different health plans approached the challenge.

11/19/2019

MA Audit Staff Playbook and Review Training
Aspire Health Plan shares their CMS MA audit staff playbook and review training materials. This training was delivered to Aspire Health Plan staff for audit readiness.

10/2/2019

Presentation: Benchmarked Best Practices for Submission Success
Cotiviti shares benchmarked industry best practices to help health plans build strong submission rates, which in turn creates increased risk adjustment program value.

10/2/2019

Recording: Benchmarked Best Practices for Submission Success Webinar
Cotiviti shares benchmarked industry best practices to help health plans build strong submission rates, which in turn creates increased risk adjustment program value.

10/1/2019

Presentation: The "Elements" for Government Lines of Business
Cognizant decribes how finding more efficient ways to meet time-sensitive data processing, analysis and compliance requirements is essential to the success of your Medicare Advantage, Managed Medicaid and Commercial Exchange Plans.

9/20/2019

De-Identified HPA member survey results CON-14 RADV
Health Plan Alliance conducts a high-level survey and quick benchmark on health plans' performance regarding RADV. Helpful for all the Medicare Advantage plans that have been chosen for the CON-14 audit.

9/5/2019

Presentation: MEDICARE: Q3 and Q4 levers to increase revenue
Centauri Health Solutions gives ideas that can assist Health Plans with creating a solid plan for closing out the year strong for gaps in care, provider communications, and risk adjustment before January sweeps and before the new HEDIS rating season.

9/4/2019

Impact of CMS Changes to the Medicare Advantage HCC Risk Adjustment Model for Payment Year 2019: Winners and Losers
A study from Avalere assesses the impact of the most recent changes to CMS risk adjustment models by looking at a key component of the models, the set of Hierarchical Condition Categories (HCCs).

7/9/2019

Quartz Medicare letter for COB
Quartz Health Solutions shares an example of a member communication about Medicare, referencing their Medicare Information form and requesting its completion.

5/23/2019

Presentation: Back to our roots - Provider and Community partners to educate and raise MA awareness
Care N' Care and Health Team Advantage share their approaches to leveraging provider and community partnerships to promote and educate on MA. Presented at the MA Marketing Materials Master Class on May 23, 2019.

5/22/2019

Johns Hopkins 2019 MA Marketing Samples
Johns Hopkins shares examples of their MA Marketing materials.

5/21/2019

Presbyterian Health Plan 2019 MA Marketing Samples
Presbyterian Health Plan shares samples of their MA Marketing materials.

5/21/2019

HealthTeam Advantage 2019 MA Marketing Samples
Samples of marketing collateral for HealthTeam Advantage's 2019 New-to-Medicare campaign for the MA Marketing Master Class (May22-May23)

5/20/2019

Prominence Health Plan: 2019 Medicare Advantage Marketing Samples
Prominence Health Plan shares examples of their Medicare Advantage marketing materials

5/20/2019

Community Health Plan of Washington 2019 Medicare Advantage Marketing Samples
Community Health Plan of Washington shares examples of their Medicare Advantage marketing materials.