RISE National Roundtable: How Engagement & Rewards Support Risk Adjustment

HealthMine’s EVP of Consulting & Professional Services Melissa Smith and EVP of Growth Kent Holdcroft recently led a roundtable discussion on member engagement and risk adjustment at the RISE National Conference. In this presentation, Melissa and Kent share how...

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Navigating Plan Preview in a Pandemic

Navigating Plan Preview in a Pandemic

On August 7, the 2021 Star Ratings kicked off with the announcement of the first plan preview. This marks the first time that official performance data on all scored measures are presented in a single report. This year CMS is allowing plans two...

Maximizing Medicare Advantage Bid Budget

Maximizing Medicare Advantage Bid Budget

Bids for Medicare Advantage and standalone prescription drug plans have been submitted for the 2021 plan year. This was no small undertaking for health plans given the regulation changes from CMS and the COVID-19 pandemic. Unfortunately, the work...

CAHPS Usurps HEDIS as King

CAHPS Usurps HEDIS as King

For Medicare Advantage plans, the HEDIS-based measures have been the focal point of the Star Rating Program for years. Even as CMS made changes to the program, strong performance in these measures was essentially a formula to reach a 4-Star Rating....