This week, our In Focus reviews a New York State Health Foundation-commissioned report titled, “An Assessment of the New York Health Act: A Single-Payer Option for New York State.” The study, conducted by the RAND Corporation, analyzes a proposal that would establish a single-payer system in New York. The proposal, known as the New York … Read More
This week, our In Focus section describes New York State’s Medicaid Section 1115 waiver amendment authorizing at least $6.7 billion in funding for new programs and initiatives in the state’s Medicaid program. The Centers for Medicare & Medicaid Services (CMS) approved New York’s application for the amendment January 9, 2024, which is effective retrospectively to April 1, … Read More
This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Authored by Suzanna-Grace Sayre and Dani Cronick and published January 2022, this paper outlines the CMS modifications to the 2022 Star Ratings due to COVID-19, quantifies the estimated impact on 2023 … Read More
This week, our In Focus reviews the Announcement of Calendar Year (CY) 2020 Medicare Advantage Capitation Rates and Medicare Advantage (MA) and Part D Payment Policies (Rate Announcement) and Final Call Letter, issued by the Centers for Medicare & Medicaid Services (CMS) on April 1, 2019. The Rate Announcement and Call Letter includes final updates … Read More
This week, our In Focus reviews the New Mexico Medicaid managed care request for proposals (RFP), released on September 30, 2022, by the New Mexico Human Services Department (HSD). The state will transition to a new program called Turquoise Care in 2024, which will build upon the current Centennial Care 2.0 program through a new … Read More
2019 New York Healthcare Provider Conference Make Your New Risk Model Pay: How New York Healthcare Providers are Making Population Health SustainableNovember 13, 2019 – Albany, New York Keynote Session – So, You Are Risk-Ready. Now What? Provider Strategies and Lessons for SuccessAlan Channing, Principal, Channing Consulting Group, LLC; Retired President, CEO, Sinai Health System; … Read More
This week, our In Focus section examines differences in Medicare Advantage (MA) churn rates among select provider-sponsored plans (PSPs) and non-PSPs. Enrollee churn rates, or rates at which enrollees switch plans, may be an indicator of enrollee satisfaction. In the years studied, PSP organizations had lower average churn rates compared to non-PSP organizations.
This week, our In Focus section reviews the annual Medicaid health plan ratings released in September by the National Committee for Quality Assurance (NCQA), which rated 171 Medicaid plans. For 2019-20, NCQA used a ratings methodology that scored each health plan from 0 to 5 in 0.5 increments – a system similar to the Five-Star … Read More
HMA works with managed care plans to maximize Star ratings and improve program quality. Star Ratings have been on a steady decline over the last two years resulting in large reductions in quality bonus and rebate payments, potentially impacting opportunities to improve member health outcomes. How HMA can help improve a plan’s Star rating: We … Read More
This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. HMA Managing Director Anthony Davis and Principal Sarah Owens rely on data from the Centers for Medicare … Read More