Recently, I was having a drink with a friend in the industry, and I started talking about our member experience roadmap. My friend made the mistake of asking me why I was…
2020 Opioid Overutilization Strategy
The Centers for Medicare & Medicaid Services (CMS) has stated its goals to improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with…
Medicare Advantage Implementation – It’s All About Asking the Right Questions
The famous economist Paul Samuelson stated, “Good questions outrank easy answers.” That is true in most things that really matter in life. It is human nature to go with the obvious easy…
What is the Cost of Non-Compliance?
In 2018, the cost of non-compliance to Plan Sponsors was more than $2 million dollars in civil money penalties (CMPs). While this is a precipitous drop from 2017’s cumulative assessment to the…
The 2020 Rate Announcement & Final Call Letter for MA & Part D
OVERVIEW On April 1, 2019, the Centers for Medicare & Medicaid Services (CMS) released final policy and payment updates to the Medicare Advantage (MA) and Part D programs through the 2020 Rate…
You Can NO LONGER Be on Autopilot! Live or Let Die to the Nationals!
This past Annual Election Period (AEP) was more active than in past years, and the results show it. There were more than 600,000 net new Medicare Advantage (MA) enrollees this AEP. The…
Top 10 Changes – Draft Medicare Communications and Marketing Guidelines
Centers for Medicare & Medicaid Services (CMS) has released the draft Medicare Communications and Marketing Guidelines (MCMG) for 2020. Of the CMS draft MCMG changes, here’s our top 10: Plans must include…
