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- Denise Gill-Vigilante on How to Efficiently Conduct an Audit
- R. Pennypacker on Compliance Highlights of the CY 2017 Draft Call Letter
- Kathleen Chapman on Is Value-Based Insurance Design All It’s Cracked Up To Be?
- Tracy Croxon on Compliance Highlights of the CY 2017 Draft Call Letter
- Ted Rever on Final Rule: The Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017
Topic: Prospective Evaluations
The Gorman Health Group 2016 Forum concluded last week with over 200 of our closest clients and partners. There was great news and rough news, so here are a few takeaways: Read more
On Friday after the close, the Centers for Medicare & Medicaid Services (CMS) released the 2017 Medicare Advantage (MA) Call Letter with proposed policy and payment changes. There’s a lot to like ‒ and much to fear. On payments, CMS came in with higher-than-expected rates that make clear the long walk in the desert from cuts in the Affordable Care Act (ACA) is over. But on compliance, they are rolling out the firing squad with a broad mandate, and the Administration will leave its mark long after Obama has left office.
Twice a year I get the honor of speaking to the California Association of Physician Groups’ (CAPG) annual summit and DC policy meeting. CAPG represents accountable, capitated physician groups, and now has members in 39 states. They’re always among my favorite speeches given how sophisticated the audiences are. Here’s a few takeaways from my talk last week on “The Future of Government Programs”: Read more
An important paper recently released in the American Journal of Managed Care shattered the notion that care management can save money on high utilizers. The article reviewed recent studies of the effectiveness of health plan care management programs and found that, while many studies show significant savings, more rigorous studies concluded that savings were “limited or nonexistent.” Mind. Blown.
We just wrapped our best-ever Gorman Health Group 2015 Client Forum at National Harbor with over 200 of our closest clients and partners. There was both great and tough news, so here’s a few takeaways, including a couple stunners: Read more
Friday, February 20th after close of business, the Centers for Medicare and Medicaid Services (CMS), released its 2016 Advance Notice of Medicare Advantage Payment, known affectionately as “the call letter.”