2020 Operational Readiness Prep – Ensure Comprehensive Processes in the New Year
I was recently flying to a client site. The Southwest plane was just boarding, and I had a seat at the window in front of the engine. I was watching out the…
The CMS Spring Conference Has Come and Gone!
The Centers for Medicare & Medicaid Services (CMS) held its annual spring conference, and although it was a shortened conference this year with four areas of discussion as well as a keynote…
Set Your Plan Apart with an OTC Benefit
Two of the buzz phrases most frequently heard in the health care community now are “value-based care” and “social determinants of health” (SDOH). Health plan leaders must leverage both to compete. SDOH…
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…
