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.
Provider Relations
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…
Bundled Payments Report Issued
Bundled payments capitate medical care at the episode level. It is one of the few…
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…