White Papers from MCOL
 

Consolidating Data to Create a Foundation of Analytics for
Revenue and Quality Management


Centralizing Data to Create a Foundation of Analytics for Revenue Management

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Medicare Advantage (MA) and Health Insurance Marketplace (HIM) plans are under increasing pressure to respond to the evolving payment models of risk adjustment and quality performance. The Centers for Medicare & Medicaid Services is progressively adjusting regulations and the financial impact related to these models. In the rapidly changing healthcare environment, successful management of risk and quality programs will remain an imperative for success. In this DST white paper, you will learn:

  1. Key data elements essential for optimal outcomes
  2. How to use comprehensive analytics to guide risk and quality strategies
  3. Approaches to integrate risk and quality operations
  4. Patient scenarios for MA and HIM health plans in risk adjustment and quality performance
  5. Impact to health plan from risk and quality perspectives.

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