Executive Briefing | November 13, 2018

Navigating CMS’ Enhanced Program Integrity—Preparing for the Spotlight

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On June 30th, CMS announced it was enhancing its Program Integrity efforts that focus on addressing improper Medicaid payments and CMS oversight of state Medicaid programs. The announcement introduced 8 initiatives, including stronger audit functions, enhanced oversight of state contracts…

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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 the world of delegated risk models, especially for Medicare Advantage (MA) populations. That’s why Pareto recommends an innovative approach to managing value-based payments,…

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Executive Briefing | May 31, 2018

Is Change Good for the Medicare Advantage Market?

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With Medicare Advantage (MA) and Part D plans entering the final stretch for 2019 bid submission, each has undoubtedly spent a significant amount of time thinking about change. In April, CMS released the final policy and payment updates for these…

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