The countdown for network development, expansion, and Health Service Delivery (HSD) submission for 2020 is upon us. It is imperative that network strategy planning starts now in order to avoid the pitfalls plans have faced in the past.
Key Components in Shared-Risk Pool Reporting
When a team works well together, the members collectively accomplish more than any of the…
Network Development in the Era of Relaxed Supplemental Benefit Regulations
As we saw in this year’s Centers for Medicare & Medicaid Services (CMS) regulations, Medicare…
How to Avoid Network Development & Expansion Pitfalls
Network management, directory accuracy, service area expansions (SAEs), and the new triennial review process have…
Blending Network Strategy and Product Strategy
As more and more health systems and provider organizations successfully manage the shift from patient…
CMS June Network Submission Deadline Fast Approaching
In early February, there was a bit of a scramble when several plans received notices…
CMS Reports Medicare Advantage Provider Directories Continue to be Plagued with Inaccuracies
The Centers for Medicare & Medicaid Services (CMS) issued its Round Two online provider directory…
CMS Announces Changes to the Network Review Process for Medicare Advantage Organizations
As anticipated, the Office of Management and Budget (OMB) approved the Centers for Medicare &…
Provider Network Management New Year’s Resolutions for 2018
Many of you and your teams are in the frantic, end-of-year trenches renegotiating current provider…
Three-Year Network Adequacy Review for Medicare Advantage Plans
If the Centers for Medicare & Medicaid Services (CMS) knocked on your door today, would…