It’s network development season, and CMS’ recent changes to network adequacy requirements merit taking a closer look at where new MA plans can take root, and where existing plans can further expand their service areas.
CMS Network Adequacy Changes & the Impact to Medicare Advantage Plans
CMS’ recent network adequacy updates will open doors for plans to provide services in counties that would have otherwise proven difficult to meet network adequacy requirements.
Strategies to Support Value-Based Reimbursement During Uncertain Times
Amidst uncertainty, risk-bearing providers and ACOs must be nimble and adaptable to mitigate losses. What strategies can be deployed to support value-based financial and clinical goals?
It’s Time to Prepare for Medicare Advantage Provider Network Submissions
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.
Blending Network Strategy & Product Strategy
As more and more health systems and provider organizations successfully manage the shift from volume-based…
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…