New CMS Proposal Overhauls ACO Program

David Sayen

When the folks at CMS manage to stand up what every Congress and the Administration has thrown their way, that really is a kind of success. When the Affordable Care Act (ACA) was finally passed, the effective date for many provisions had already passed. Standing up the Medicare Shared Savings Program (MSSP) and the other ACO demonstration models was a heroic effort, but the programs themselves weren’t perfect, nor could they be.

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Build a Better Medicare Advantage Enrollment Experience

Convey Health Solutions

Large Medicare Advantage carriers invested a median of $11.25 per member per month in marketing in 2015, and …

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Webinar Recap: 2019 MCMG Highlights

Diane Hollie

Thank you to all who came to the Gorman Health Group (GHG) webinar regarding the 2019 Centers for Medicare …

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First Plan Preview of 2019 Star Ratings Data

Melissa Smith

It’s official – the Star Ratings “busy season” is underway! As is always the case, the Centers for …

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CMS Takes Action to Lower Drug Prices, Permits Step Therapy

Heidi Harmon

I have been known to utter “holy cow” in my day, and the recent Centers for Medicare & …

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Open Enrollment and Risk Adjustment

Debra Faulkner

As for many who are in the depths of risk adjustment, you may be just coming up for …

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CMS released proposed changes to payment rule for Durable Medical Equipment Prosthetics, Orthotics, and Supplies

David Sayen

In one episode of the Sopranos, Tony’s brother-in-law runs up a gambling debt with the mob.  Tony and …

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