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Health PlansThe heart of our business lies in serving Medicare managed care plans. Since the MMA’s passage in 2003, we have brought dozens of Medicare Advantage (MA) plans, Medicare Prescription Drug Plans (PDPs), and Medicare Special Needs Plans to market, representing over 100 contracts. Many payers have turned in recent years to their govenment business to be a driver of membership and revenue growth. The most visionary plans have awoken to the reality that these products also serve as something of a precedent for managing the opportunities presented by health reform. But because the government business is so different than commercial products, operating these lines of business on a commercial platform or with a commercial mindset will not yield success. Even those plans who strive to "get it right" from the start are challenged by the pace of regulatory change and the tightening revenue environment.
The heart of our business is our work on behalf of Medicare managed care plans, helping them thrive in this high-stakes, and high-opportunity environment. Over the years we have brought many dozens of Medicare Advantage (MA) plans, Prescription Drug Plans (PDPs), and Special Needs Plans (SNPs) to market, and helped countless others thrive in the government programs market. In addition serving as the trusted partner of over 50 health insurers--representing hundreds of plans--a year, we maintain active practices for providers, PBMs, and a host of other ancillary industries. This gives us an unmatched perspective on the health plan business environment. We invite you to learn more inside. Star RatingsUnder the health reform legislation, payment to Medicare Advantage plans is linked to a beneficiary’s experience and quality of care. For the first time, high performing plans will be paid more than lower performing plans. This changes the terms of market competition and turns incentives in Medicare Advantage towards improving quality. ComplianceWith the Centers for Medicare and Medicaid Services (CMS) scrutinizing Medicare plans more closely than ever, compliance is again a front and center plan priority. The costs of non-compliance with CMS are significant. PharmacyIn an era of heightened competition for members and increased regulatory scrutiny, how can you ensure your marketing and sales efforts are both effective and compliant? Medicare Product DevelopmentMedicare product strategy and development should be thought of as a cycle that culminates in the sales activities that occur each Annual Election Period in November. Document Actions |
