CMS recently released the 2022 Advance Notice Part 1, with a heavy emphasis on the shift from RAPS to EDS to calculate risk scores. Here’s what you should know.
Tag: Medicare Advantage
Network Development Season is Upon Us
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.
2021 Chapter 2 Enrollment Changes
CMS recently released the 2021 Chapter 2 Enrollment Changes. GHG’s VP of Sales, Marketing & Strategy, Diane Hollie, summarizes the key changes here.
Why the OEP is So Important This Year
A global pandemic and Presidential election year have created uncertainty surrounding this year’s AEP. However, there are a few things we know for certain and this year, health plans should be prepared with an intentional OEP strategy.
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.
CMS’ Proposed Addendum to Part C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance
On July 7, 2020, CMS distributed a draft addendum to address changes required for Integrated DSNPs for Unified Appeal and Grievance processing in the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance. Noteworthy changes are summarized here.
On Demand Webinar: AEP Sales Strategies for a Pandemic & Presidential Election
GHG recently held a virtual roundtable with leaders from Blue Cross and Blue Shield of Louisiana, HPOne, and Senior Market Sales discussing AEP sales strategies during a pandemic and presidential election. Read a synopsis of the topics covered and watch the webinar recording on demand.
Building a Successful Social Determinants of Health Strategy
In the midst of a viral pandemic and evolving social movements, developing a robust SDOH strategy is more important now than ever before.
Confirmed Star Ratings Changes in CMS’ Final Rule
With CMS’ release of the Contract Year 2021 Final Rule, MA plans now have some clarity regarding the many Star Ratings proposals made earlier this year.
What are MedPAC’s April 2020 Star Ratings Recommendations?
With MA enrollment soaring, COVID-19 presenting still-developing threats to Medicare, and the Medicare Trust fund approaching insolvency, MedPAC continued emphasizing the need for urgently reforming the MA Quality Bonus Program during its April 2nd public meeting.