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Executive Briefing | April 30, 2019

The Rise of Over-The-Counter Programs in Medicare Advantage Plans

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A review of the 2019 Medicare Advantage Annual Enrollment Period Supplemental Benefits reveals that the growth of Over-The-Counter (OTC) programs far outpace any other newly…

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Executive Briefing | March 5, 2019

Value-Based Care Requirements in Medicaid

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The absence of meaningful value-based requirements in state contracts does not indicate a “do-nothing” scenario. MCOs that lay the groundwork for advancing internal VBC initiatives…

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News | November 16, 2018

HealthScape Advisors Combines with Convey Health Solutions

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The combination of Convey, HealthScape, and Pareto solidifies our market position as the go-to partner for health plans to optimize member experience and outcomes, ensure…

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Executive Briefing | November 13, 2018

Navigating CMS’ Enhanced Program Integrity—Preparing for the Spotlight

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CMS recently announced that it was enhancing its program integrity efforts that focus on oversight of Medicaid programs. How should health plans respond?

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Executive Briefing | October 30, 2018

Wait… MACRA Impacts Med Supp?

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Because a provision in MACRA eliminates first dollar coverage, plans can no longer sell the most popular Med Supp plans C and F. Success in…

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hfm Magazine | September 6, 2018

Integrated Revenue Cycle: Coordination Between Insurers and Providers to Ensure Revenue Accuracy

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Traditional revenue cycle management arrangements that focus solely on billing and collections are no longer reliable. In a world of delegated risk models, providers must…

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Executive Briefing | May 31, 2018

Is Change Good for the Medicare Advantage Market?

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Recent CMS announcements have imposed a lot of change on the Medicare Advantage market. From enhanced benefit flexibility to permanent authorization of SNPs and more,…

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Whitepaper | May 23, 2018

Assessing Joint Venture Models for Provider-Sponsored Health Plan Products

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Recent market activity seems to indicate that joint venture provider-sponsored health plan products are on the rise. Are you considering this strategy? If so, there…

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Executive Briefing | March 20, 2018

Value-Based Contracting: How to Think Like a Payer

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Providers entering into risk arrangements should take a proactive approach and “think like a payer” in their communication and process for these contract structures and…

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