Advantmed offers integrated solutions to help healthcare organizations improve performance.
Effective member engagement allows a health plan to accurately assess the health status of its members. Engaged members are more likely to participate in their healthcare, seek information about providers, and adhere to treatment plans—all of which lead to better health outcomes and lower costs. Members who take an active role in their health and… Continue reading Three Strategies to Improve Member Engagement
On March 31st, 2023, The Centers for Medicare & Medicaid Services (CMS) published the Final Rate Announcement for PY 2024. This is an update to the previously published CMS Advance Notice on February 1st, 2023. We’ve put together a recap of these proposed changes below: Risk Adjustment Changes The following provides a high-level overview of… Continue reading CMS Final Notice: A Clinical Perspective
The Centers for Medicare & Medicaid Services (CMS) has had a busy 2023 already with a flurry of regulatory activity. We saw the CMS RADV Final rule published on Jan 30, 2023 and the CMS Advance Notice for PY 2024 published on February 1st, 2023. Impact to risk adjustment and quality programs were minimal in… Continue reading CMS Advance Notice: A Clinical Perspective
On January 30th, CMS released its Final Rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. You might be wondering how these new RADV rules will impact your MAO. Here are a few points to consider. 1. Many conditions in the Medicare Advantage population continue to be inappropriately coded 2. CMS has… Continue reading The RADV Final Rule: What You Need to Know
“Not everything that can be counted counts, and not everything that counts can be counted” – Albert Einstein. We could not agree with this more, especially when it comes to managing your membership and the risk score of that population. The definition of risk adjustment and its stated purpose is as simple as a process… Continue reading Optimizing Your Risk Adjustment Program: Top KPIs to Measure Success
Providers hold the key to successful medical record retrieval. This means that developing positive relationships and limiting abrasion must be a priority and a core competency for every record retrieval vendor.
For quality improvement initiatives, prospective monthly runs can give you better insight and help you stay on top of results.
Change can be stressful, especially when it comes to HEDIS®. With several updates anticipated in the coming months and years, you need to be prepared. Advantmed’s HEDIS experts have been monitoring the National Committee for Quality Assurance (NCQA) and the market overall. Based on our research, we have summarized several important changes anticipated for 2020 and… Continue reading HEDIS® 2020: What You Need to Know Now
At Advantmed, we focus on helping health plans optimize risk and improve quality. Part of that preparation involves making sure you’re ready for a possible RADV audit. Michelle Zilisch, Advantmed’s Director of Client Solutions, has been in the trenches with many health plans. In this seven-minute webinar, Michelle shares three key tactics you can employ… Continue reading Download our webinar, Best Practices: Three Key Steps to Minimize RADV Exposure
By Vandna Pandita, Vice President, Client Engagement & Product Operations Fall, winter and then HEDIS®. Yes, HEDIS. It is its own season for many of us that work in healthcare. However, the images of HEDIS season are quite different from other seasons. It is not defined by the temperature, the color of the leaves or… Continue reading HEDIS® Season is the Reason: Make Year-round Preparation Part of Your Strategy
