Maintain compliance with the Office of Management and Budget’s (OMB) new race and ethnicity guidelines with a breakdown of the key changes. The OMB’s new rules require Medicare Advantage, Medicaid Managed Care and Dual-Eligible Special Needs Plans to re-evaluate how they capture member data. Get ahead of OMB’s guidelines by addressing four key areas: https://lnkd.in/gWEQxJbk
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Explore the complexities of state-level regulations that may impact your 340B program with our latest article in the 340B Report! Paul Melland, Sr. Director of Client Success, dives into it all - from Medicaid nuances to legislative updates. Find key insights to safeguard your program at the link below. https://bit.ly/4dzrc2J
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The recent HHS Office of Inspector General report underscores the challenges faced by Medicare Advantage enrollees due to prior authorization issues, resulting in denials and delays in essential care. This highlights the critical need for streamlined processes to ensure timely access to necessary services. Collaborative efforts from the Centers for Medicare & Medicaid Services, Congress, and industry leaders have already yielded positive changes, emphasizing the importance of ongoing reform in healthcare delivery. #MedicareAdvantage #HealthcareReform #PriorAuthorization #Healthcare #Medicare
New impact brief on Medicare Advantage prior authorization highlights one of the many impacts of HHS-OIG's oversight work. Read more: https://direc.to/fhYt
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Much needed step in the right direction with regards to access of healthcare
New impact brief on Medicare Advantage prior authorization highlights one of the many impacts of HHS-OIG's oversight work. Read more: https://direc.to/fhYt
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In a new white paper, Duke-Margolis researchers provide a path forward on modernizing data collection for use in risk adjustment and model calibration to reflect the growing share of accountable care. Risk-adjusted payments remain based on claims data from beneficiaries in fee-for-service care, resulting in fundamental challenges and biases in their use for payment. Read the authors’ recommendations here: https://duke.is/8/psk8
Modernizing Medicare Risk Adjustment and Performance Measurement
healthpolicy.duke.edu
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Download our white paper to see how The Work Number® equips state Medicaid agencies with current income and employment data to possibly help improve ex parte renewal rates: https://ow.ly/pgFx50QpcF5
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Download our white paper to see how The Work Number® equips state Medicaid agencies with current income and employment data to possibly help improve ex parte renewal rates: https://ow.ly/JFEb50QlqvP
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Understandably, there is a need for check and balance when it comes to medical necessity and claim coverage. However, over the past few years, the constant shifting in requirements to get authorizations for interventional procedures has had a profound effect on our healthcare providers. See the latest on Medicare Advantage in a post from the Department of Health and Human Services below.
New impact brief on Medicare Advantage prior authorization highlights one of the many impacts of HHS-OIG's oversight work. Read more: https://direc.to/fhYq
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Download our white paper to see how The Work Number® equips state Medicaid agencies with current income and employment data to possibly help improve ex parte renewal rates: https://ow.ly/YuSb50Qmoep
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Back pain is the most common diagnosis given to Medicare patients. Does this surprise you? I've been exploring a Medicare claims dataset to sharpen my data analysis skills, and my thoughts are up on GitHub now!
GitHub - ehaynie63/medicare-carrier-line-items: A review of Medicare claims data
github.com
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Download our white paper to see how The Work Number® equips state Medicaid agencies with current income and employment data to possibly help improve ex parte renewal rates: https://ow.ly/UGSZ50Qluli
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