Building Trust in Healthcare Payer Data: 3 Keys to a Reliable Data Quality Strategy
In the age of big data, healthcare payers and third-party administrators (TPAs) are overwhelmed by vast amounts of information, underscoring the importance […]
2026 CMS Interoperability and Prior Authorization: Key Strategies for Healthcare Payer Readiness
In January 2024, the Center for Medicare and Medicaid Services (CMS) issued the Interoperability and Prior Authorization Final Rule CMS-0057-F, heralding a […]
Facts About 2022 Medicare Advantage Plans
We find it fascinating how the Medicare Advantage industry changed exponentially in the past decade. With Medicare Advantage Plans now being a […]
Alex Morrison Explains Software Architect’s Responsibilities
This month we are spending some time with Alex Morrison, Solutions Architect to learn about his daily activities and team accomplishments and […]
Developing Care Management through Analytics
In today’s healthcare climate, where pay for performance and shared savings models are the new norm, using analytics creates the blueprint for […]
CMS Changes to 2021 & 2022 Star Ratings Data Calculations
The Centers for Medicare & Medicaid Services (CMS) announced it will “put patients over paperwork to provide temporary relief from many paperwork, […]
Andy Parker, Director of Administration Services Talks Progress
This month, we are connecting with Andy Parker, Director of Administration Services about his department projects, team, and client relations. What have […]
Medicare Advantage gets supplemental benefits flexibility, including for transport
MA plans must still offer all enrollees uniform benefits, premiums and cost sharing. “Under the bipartisan budget deal signed by the president […]
AHIP asks CMS to change Medicare Advantage payment formula
The Centers for Medicare and Medicaid Services should update its county benchmark calculation in the 2019 final notice being published April 2. […]
CMS offering $30 million in grant funding to improve quality measures
The funding is to develop partnerships with health systems, clinicians and others to improve measures in the quality payment program of MACRA. […]