CMS recently released the 2021 Program Audit Memo announcing that it will start sending engagement letters in March 2021, but health plans should remain diligent about audit preparation and their PBM oversight activities.
Tag: COVID-19 Pandemic
Part II of the CY 2022 Advanced Notice: Continued Evolution of the Medicare Advantage Star Ratings
CMS recently surprised plans with the early release of Part II of the CY2022 Advance Notice, with several updates impacting Star Ratings. GHG’s Jessica Assefa summarizes the noteworthy changes here.
MA Plans See Lower 2021 Star Ratings on Average
The 2021 Star Ratings Program results have been released, and fewer MA plans received high Star Ratings. What does this mean for plans as we look toward the 2022 Star Ratings timeline?
The Value in Shifting to a Value-Based Care Model
The pandemic has shown us that the fee-for-service model was just as fragile as we thought it was. There is now a tremendous sense of urgency to change the way in which care is provided, and making the shift to value-based care may be the key to success.
AEP Marketing During COVID-19 …AND a Presidential Election
Developing a marketing strategy during a Presidential election year is difficult enough. But adding in the current, and eventually, post-COVID-19 environment, which is unprecedented, makes it even more challenging. How can you rethink your AEP marketing strategy?
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?
MA Plans Should Pivot Due to COVID, Election Impact This Fall
In the fall, plans will be challenged by the double whammy of a presidential election and a predicted second outbreak of COVID-19. This AIS Health article in Health Plan Weekly shares some insights from a recent GHG/Deft Research webinar and the product strategy implications of a changed selling environment.
CMS Releases Interim Final Rule for COVID-19 Regulatory Changes
On March 30, 2020, CMS released the interim final rule with comment period (IFC) to address a variety of payment and provider practice needs in response to the COVID-19 pandemic. Read the key takeaways for Star Ratings, Provider Flexibilities, and Telehealth.