Sedna Consulting Group’s Post

Reflecting on recent insights from KFF, it's evident that despite its challenges, Medicaid unwinding has catalyzed significant improvements in enrollment and administrative efficiency across states. The opportunity to retain waiver flexibilities—like automatic renewals and leveraging updated health plan data—is pivotal for health plans. These initiatives streamline processes and enhance transparency and accessibility, aligning with our goal of simplifying healthcare access for all. https://bit.ly/4bwhoEm via Healthcare Dive #Medicaid #healthcare

🏥💡 Transforming Healthcare with Data and Innovation! 🚀💰 The Affordable Care Act and the Center for Medicare and Medicaid using data to change payment models prompted the creation of Gray Matter with a focus on analytics for payment models due to healthcare lagging in technology adoption. The convergence of these factors provided the impetus to drive innovation in the healthcare industry. 📊💻 Watch the full video here: https://buff.ly/43xSNN4 #HealthcareInnovation #DataAnalytics #TechInHealthcare 🏥💡 #AffordableCareAct #Medicare #Medicaid #PaymentModels 🚀💰 #HealthcareTechnology #InnovationInHealthcare #DigitalHealth

Many healthcare organizations operate day after day without reaching an optimal level of revenue generation. Is yours one of them? Let's find out. Download a copy of our guide to revenue cycle management best practices, “7 Steps to Optimizing Your Revenue Cycle Management.” Inside, you'll find: 📊 Key performance metrics 📍 Tips for records management, including eligibility 🔑 The key to improving Medicare Advantage reimbursements 💰 How to understand gross vs. net margin ✅ Best practices in revenue optimization and more Get your copy for free at: https://bit.ly/4aFymQx #FQHC #MedicalBilling #Healthcare #BehavioralHealth #RuralHealthcare #MedicalBilling #MedicalCoding #RCM #CommunityHealth #Medicaid #Medicare #HealthcareBilling #MedicalCredentialing

Hey health payers: Need a solution that meets the new prior auth requirements? Have you considered how you’ll handle out of network providers and meeting the reporting requirements? Read on!

📣 Last chance to register! Sign up now for our webinar to learn about the current state and best practices of Medicaid Unwinding. 👉🏻 Save your spot: https://hubs.la/Q02mkHXx0 Learn from our leaders as they dive into real-world instances and efficient methodologies for raising awareness and encouraging members to proceed with their redetermination. Key Takeaways: ✔️ Uncover the root causes of dropped members and explore opportunities to improve ✔️ Gain a fresh perspective on the future of Medicaid renewal processes ✔️ Learn best practices for effective communication during redetermination and future renewals #MedicaidRedetermination #Medicaid #Redetermination #HealthCare #HealthTech #HealthcareEquity #HealthcareQuality #CXA #CX #Automation #AI #webinar

Dive deep into the impact of the new CMS Prior Authorization Rule with insights from our own John Zimmerer, VP of Healthcare. https://bit.ly/3IXl9Xm On January 17, 2024, CMS finalized its rule on data interoperability and prior authorizations (PAs), sparking significant changes in healthcare operations and technology. In this article, John addresses key questions about the final rule and its implications for health payers. Read the full article here: https://bit.ly/3IXl9Xm #MedicareAdvantage #Medicaid #Healthcare #Payers #PriorAuthorization #CMS #CMSRule

At Altruis, we understand the value of good work done right. We cover every aspect of the revenue cycle and optimize factors to promote revenue growth, enhanced organization and administration, and other valuable improvements for healthcare organizations. Learn how Altruis gets it right the first time: https://bit.ly/3wXxyIJ #FQHC #MedicalBilling #Healthcare #BehavioralHealth #MedicalBilling #MedicalCoding #RCM #CommunityHealth #Medicaid #Medicare #HealthcareBilling #RCM #RevenueCycleManagement

Payers with government and employer-sponsored health plans can extend core system functionality with customized tools that automate quality management and government programs processes. See how these solutions can drive efficiency, enhance revenue potential and keep you compliant. #Healthcare #Payers #Medicare #Medicaid #CommercialExchanges #GovernmentHealthcare #TriZettoElements Cognizant https://cogniz.at/3VTeky2

Over the last 5 years, the number of Medicare beneficiaries enrolled in special needs plans (SNPs) has more than doubled (2.92 million in 2019 vs. 6.64 million in 2024). Additionally, enrollment in SNPs has seen a 16% increase since 2023 and currently accounts for 20% of overall Medicare Advantage enrollment. RAM Technologies (Health Plan Software) offers comprehensive software and service solutions for health plans administering Medicare Advantage and Special Needs plans, available in both SaaS and BPaaS options - learn more here: https://lnkd.in/eCSai3rG Learn more about SNP enrollment & Medicare Advantage trends from KFF Health News: https://lnkd.in/gNZ-m_gh #medicare #medicareadvantage #medicaid #saas #healthcare #healthtech #healthplans

At Altruis, we understand the value of good work done right. We cover every aspect of the revenue cycle and optimize factors to promote revenue growth, enhanced organization and administration, and other valuable improvements for healthcare organizations. Learn how Altruis gets it right the first time: https://bit.ly/3VB3Q5X #FQHC #MedicalBilling #Healthcare #BehavioralHealth #MedicalBilling #MedicalCoding #RCM #CommunityHealth #Medicaid #Medicare #HealthcareBilling #RCM #RevenueCycleManagement