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.


  • 10/12/2018
  • Chronic Care Management Services Fact Sheet
  • Shared by Health First Health Plans, this CMS fact sheet provides background on payable CCM service codes, identifies eligible practitioners and patients, and details the Medicare PFS billing requirements.
  • 5/22/2018
  • From ACO to MA: Time To Grow Up
  • Lumeris presents a comparison of CMS ACOs to MA and provides considerations for long term MA strategy. This presentation was given on April 26, 2018 at the NAACOS Spring Conference.
  • 10/19/2017
  • Value Based Payment Survey Results: How Provider-Sponsored Plans Can Succeed
  • During this webinar, HealthScape Advisors explore the value-based payment survey results and their impact and implications. We encourage you to Invite your health system and medical group executives to join you on the webinar. Feel free to forward them the report with your invitation. The recommendations in this report can be successful when approached through the entire enterprise and this is an opportunity designed to bring together the stakeholders.
  • 9/13/2017
  • You can't spell MACRA without MA
  • Is your organization MACRA ready? If so, you've probably invested significantly in infrastructure and innovative policies and procedures focused on care management and consumer engagement strategies. But have you considered how this investment has prepared you for the broader Senior Market? Synergies across both MACRA and Medicare Advantage may exist.