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Medicare Advantage Star Ratings: Expectations for New Organizations
traditional FFS Medicare Part A (hospital and long- term care services) and Part B (outpa- tient and professional ... Prescription Drug Plans (PDPs), Program of All- Inclusive Care for the Elderly (PACE) plans, Cost plans, Medicare- ...- Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Is Your Integrated Delivery System Throwing Away Free Money?
of both the delivery and the insur-ing of health care should be powerful. That is the theory behind an ... explain why. Optimizing value in an integrated health care delivery system requires aligning the financial ...- Authors: Karan Rustagi
- Date: Feb 2018
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
The results are focused primarily on coordinated care plans (local HMOs, local PPOs and regional PPOs) ... Gender CHART 1 HCC Survey Results Coordinated Care Plan members (1) Includes All 70 HCCs (2) CHART ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23
Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23 Medicare Advantage ... accurately complete such an allocation. MAOs must take care to comply with CMS guidance. This will minimize ...- Authors: Michelle Wahab, Shelby Weber
- Date: Mar 2019
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Social Insurance>Medicare; Technology & Applications>Data warehousing