Oct 1, 2020 | Medicaid Managed Care
CMS released Part I of its 2022 Medicare Advantage Advance (MA) Rate Announcement earlier than expected. This notice proposed changes to the 2022 risk adjustment model for MA plans – a key component of MA payments – including full reliance on MA encounter data to measure enrollees’ health. Click to read more.
Sep 28, 2020 | Legislation/ Budgets/ Macro
Academic researchers are increasingly looking at private equity’s role in healthcare. BRG reviewed recent articles assessing the role between private equity acquisition on provider financials and quality of care. Click to read more.
Sep 25, 2020 | Managed Care Friday
12: Percent of hospitals receiving incentive payments for reducing cesarean sections and meeting quality goals related to episiotomies, early elective deliveries, and maternity care under a pilot from Tricare set to conclude in March 2021. Tricare, which provides healthcare coverage to 9.6 million uniformed service members, retirees, and their families, has several value-based initiatives underway. 3,640 hospitals participated in the maternity pilot. Asthma Device: Anthem is pairing with UC-Irvine to study whether smart devices can help asthmatics predict an asthma attack. Anthem members...
Sep 24, 2020 | BRG Publications, Medicare Advantage
BRG finds that 2015 MA encounter data is not an analytic-ready data set for researchers to evaluate utilization or quality of care among MA enrollees. This report highlights the importance of data cleaning and preparation before the data is used and offers areas of strength and weakness by MA contract and provider type, helping to guide researchers who have access to the 2015 and later MA encounter data and wish to evaluate care delivered by MA plans. Click to read more.
