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Conquering the Plan All-Cause Readmissions (PCR) Measure

CMS is consistently evolving the Star Ratings system to ensure high-performing, high-value plan options for Medicare Advantage (MA) members. In

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The Stars Have Re-Aligned (Again): What Medicare Advantage Plans Need to Know

American Journal of Managed Care – With the 2024 Star Ratings in the rearview, Medicare Advantage plans may have received

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How to Improve Star Ratings Outcomes and HEI Performance for Dual Special Needs Plans (D-SNPs)

The circumstances in which people live, work and spend their free time have an enormous impact on their intrinsic well–being.

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SDOH-Sensitive Adherence Strategies for MA Health Equity Index Success

American Journal of Managed Care – The need for health equity spans the entire healthcare ecosystem, including the Medicare Advantage

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Using the Quintuple Aim to Prep for CMS Star Ratings QI Hold Harmless Provision Changes

2024 and 2025 are set to be challenging years for Medicare Advantage (MA) plans, thanks to CMS’s extensive proposed changes

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The Quintuple Aims of Improving Health Care Outcomes and the Impact of Medication Adherence

First Report Managed Care – The Quintuple Aim of Health Care addresses health disparities through the inclusion of its fifth

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Preparing for Massive MTM Program Expansion: Pharmacy-Led Medical Cost Savings to Fund CMS Changes

American Journal of Managed Care – CMS estimates its MTM program changes will increase enrollment from 4.5 million to 11 million MA

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Member Engagement Combined with HEDIS Strategy: Key to Star Ratings Improvement 

Change is constant in the Medicare Advantage (MA) market. Coming off some transformative adjustments to scoring calculations (e.g., “TukeyGate,” guardrail

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The Impact of Stars 2024

The Impact of Stars 2024: An Interview with Industry Leader Mick Twomey

The PP2 results were concerning, if not alarming, for many MA plans. And now, with the subsequent release of the

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Aspects of Social Determinants of Health: Defining and Sharing

Healthcare IT Today – Social determinants of health (SDOH) barriers present a challenge to many managed care members trying to

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