Insurers expect that the Centers for Medicare and Medicaid Services' recent advance notice for Medicare Advantage and Part D plans for the 2024 coverage year will result in a 2.27% cut to plans if finalized, and this could have a negative impact on members' premiums and benefits, as well as slow MA growth, according to a new Avalere study commissioned by Better Medicare
The best way for insurers to make sure they're in compliance with the mandates of risk adjustment is to use natural language processing for accurate documentation and auditing, according to Dr. Calum Yacoubian, director, Healthcare Strategy, Linguamatics, an IQVIA company that offers an NLP-based AI platform. Last week's publication of the final rule for risk adjustment data
Increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement and positive behavior changes among network providers, according to a new report from information technology company IllumiCare. The report demonstrates, across multiple plans, that placing previously unavailable information on quality gaps,
I was listening carefully to the health plan numbers announced for enrollment and what trends they were seeing as to growth in Medicaid members versus commercial and Marketplace enrollment. Thankfully, none of the health plans reporting shared troubling numbers.