Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

CMS Star Rating

Medicare Advantage Plans Proliferate in 2019, Raising Competition

October 22, 2018 - Medicare Advantage (MA) payer competition is increasing significantly for plan year 2019 as more than 400 new options hit an already-crowded market, says a new report from the Kaiser Family Foundation (KFF).   More than 2700 different Medicare Advantage plans will be available nationwide in 2019, forcing payers to differentiate their offerings and include benefits that can attract...


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CMS Releases 2019 Medicare Advantage Health Plan Star Ratings

by Thomas Beaton

CMS has released its 2019 star ratings for Medicare Advantage (MA) health plans, noting that the Medicare Advantage market continues to grow in affordability and access for consumers. CMS estimates that 74 percent of MA beneficiaries will...

Earning Top Medicare Advantage Ratings Requires Data, Ambitious Goals

by Thomas Beaton

Succeeding in the highly competitive Medicare Advantage (MA) market requires more than just a sense that there are financial gains to be had in this growing health insurance segment. Payers that wish to reap some of the many financial...

Da Vinci Project Connects Payers, Providers, FHIR for Value-Based Care

by Thomas Beaton

Payer and provider members of the Da Vinci Project are undertaking a series of pilot projects exploring how to best leverage FHIR for data exchange to enhance value-based care. “Da Vinci is a collective initiative of concerned,...

Top 10 Highest Performing Medicare Advantage Health Plans

by Thomas Beaton

Medicare Advantage (MA) plans are growing in popularity as an aging consumer population seeks comprehensive coverage for acute and chronic care needs. A competitive, lucrative market for high-performing plans has emerged, giving payers an...

Medicare Advantage Star Ratings Tied to Member Socioeconomic Strata

by Thomas Beaton

Medicare Advantage (MA) health plans with a greater proportion of socioeconomically challenged members are more likely to have lower star ratings, according to new research from Brown University. Insufficient risk adjustment criteria in...

How the Medicare Advantage Market Can Offer Payer Opportunities

by Thomas Beaton

Medicare Advantage (MA) market data from A.M Best and the Kaiser Family Foundation reveals that the MA market has remained profitable and provides financial opportunity, but payers looking to enter into the market should expect to address...

CMS Releases 2018 Medicare Advantage Star Ratings for Health Plans

by Thomas Beaton

CMS has updated the 2018 Medicare Advantage star ratings on health plans, allowing consumers to explore options that will best suit their individual needs.   The star ratings are based on several consumer engagement and care quality...

House Introduces Bill to Delay CMS Hospital Star Ratings

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) hospital star ratings may be postponed due to a new bill introduced on Monday, July 25 by House Representatives Jim Renacci (R-OH) and Kathleen Rice (D-NY). The reasoning for the delay...

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