Posts

Why Hard-to-Reach Members Aren’t the Problem: Rethinking Member Engagement 

For years, health plans have used terms like “hard-to-reach” and “unengageable” to describe members who do not respond to outreach.

Improving COB and Poly-ACH Performance Starts with Stronger Provider Partnerships

For Medicare Advantage plans, medication safety is both a performance- and outcomes-influencing factor that’s become a permanent fixture within the

AI Can Predict Which Members Will Struggle, But Can It Change Their Behavior?

Healthcare organizations are swimming in member data. With AI and predictive analytics, it’s much easier identify patterns in that data

Medication Adherence: The Effective, Yet Elusive, Key to Managing Chronic Disease 

Medication adherence sits at the center of chronic disease management. When members don’t take medications as prescribed, even the most effective treatment

Midyear Check-In: What Medicare Advantage Plans Should Prioritize Before Year-End

By midyear, Medicare Advantage plans have a much clearer picture of their Star Ratings performance. Early trends have emerged, high-risk

Beyond Compliance: How Language Access Improves Adherence, Health Equity and Outcomes 

As a clinical pharmacist, I’ve spent my career helping patients understand their medication and navigate increasingly complex healthcare decisions. One

Uncertainty Ahead? Why MA Plans Must Stay Focused on Outcomes-Based Performance  

The 2027 Final Rule remains the governing rule—and outcomes still matter  For years, Medicare Advantage Star Ratings performance has been

Understanding and Acting on New Medication Safety Measures to Improve Patient Safety: Frequently Asked Questions

As CMS continues shifting Star Ratings and quality programs toward outcomes-based performance, medication safety has become an increasingly important area

The Science Behind Better Adherence: Why Care Navigators Drive Results

Medicare Advantage plans are under increasing pressure to improve member health and outcomes— and that pressure is only accelerating. With

AI in Healthcare: Why Data Integrity and Human Insight Matter

Artificial intelligence is rapidly moving from experimentation to early-stage adoption across the healthcare ecosystem. For Medicare Advantage plans in particular,