May 2017 Newsletter

CMS seeks to attract more patients, docs to ACOs

The CMS is trying to boost patient and provider participation in accountable care organizations by automating the process to pair patients with doctors enrolled in the care models. In the coming weeks, a Medicare beneficiary can go to a website that contains their enrollment information and list his or her primary-care doctor. If that doctor is in an ACO, they would be assigned to both that provider and their ACO starting next year. Read the Entire Article here.

Medicare Advantage plans score several wins in rates for 2018

CMS released a final notice detailing changes to how it calculates Medicare Advantage (MA) plan payments, as well as bigger-than-expected payment rate increases for 2018. Health insurance companies received a gift from the federal government last week. The 2018 Medicare Advantage rate policies included a better-than-expected pay bump and industry-friendly policies. Payment rates for insurers that sell Advantage plans will rise by 0.45% on average for 2018, the CMS announced. That’s a slight bump from the 0.25% rate increase proposed in February. The average payment rate will increase by 2.95% after taking into account the way health plans code their members’ diagnoses, the CMS said. Read the Entire Article here.

Insurers, Model Risk Management Deserves Your Nod

Risk management, and the development and use of models are two skills that the insurance industry has usually performed well. Now the role of risk management is being expanded to ensure that models deliver on their target goals. This is especially important since the insurance market is experiencing a new level of competition and regulation that increases the industry’s dependence on models. Read the Entire Article here.


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2017-08-15T17:25:43+00:00