Our new eBook explains the three opportunities for excellence that Medicare Advantage plans must pursue to excel in today's ultra-competitive marketplace.
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As OIG raises concerns about beneficiaries' access to care, purposeful, informed decision-making will drive successful financial and clinical results for Medicare Advantage plans.
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Learn how analytics, prospective risk adjustment, and member engagement campaigns can effectively smooth risk scores when managing an influx of enrollees.
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Learn the three key areas that Medicare Advantage plans should bolster within their risk adjustment programs to excel in today's competitive environment while helping ensure premium accuracy.
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Understanding the 2022 CPT code changes %% Watch the on-demand webinar
Watch WebinarRISE co-chair RaeAnn Grossman explains how Medicare Advantage plans can limit audit exposure and offers other risk adjustment advice for 2022.
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Medicare Advantage plans will see a major 8.5% increase in revenue from the final 2023 Medicare Advantage and Part D Rate Announcement released by CMS.
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Learn how Cotiviti's suite of prospective and retrospective Risk Adjustment solutions enable plans to illuminate the holistic health status of their member populations to achieve premium accuracy.
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Cotiviti leaders break down the 2023 Medicare Advantage and Part D Advance Notice as CMS prioritizes health equity measurement.
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Learn a "next best action" approach to analytics at the member level with the potential to deliver tangible impact for both risk adjustment and quality improvement programs.
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By working in unison, risk adjustment and quality teams can better understand where care gaps exist and the most effective ways to deliver high-value care to disengaged or disenfranchised members.
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Health plans complete in-home health assessments (often called health risk assessments) for their members for several reasons: accurately documenting members’ risk burden, supporting...
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Risk adjustment—and the complex nature of the processes involved—is often misunderstood. Learn the fundamentals health plans must master to be successful.
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As routine medical services are cancelled or postponed due to COVID-19, prospective risk scores used to pay Medicare Advantage (MA) health plans in 2021 are trending lower than...
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Learn best practices to optimizing commercial risk adjustment revenues while maintaining total compliance.
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The public comment period has just closed for the calendar year (CY) 2022 Medicare Advantage (MA) and Part D Advance Notice recently released by the Centers for Medicare & Medicaid...
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Cotiviti's experts break down the >300 changes to the 2021 CPT code set, including a major overhaul to office and other outpatient E&M services.
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Updated in 2022 for DxCG's 25th anniversary, this is the story of the birth and evolution of one of the earliest and most accurate risk assessment and predictive modeling solutions in the industry.
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The Centers for Medicare & Medicaid Services (CMS) recently released the health plan-specific 2019 benefit year risk adjustment transfer payments. As part of the Affordable Care Act...
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Ensure compliant, accurate compensation for the risk burden of your members
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Accurately document disease burden and close care gaps
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