Future of Stars

Future of Stars

Author: Sponsored by HealthEdge June 6, 2022 Duration: 11:51
“Maintain the spirit of continual improvement across the organization. Even though there is uncertainty, CMS rewards heavily for improvement year over year.” 2021 was the first year that CMS shifted away from clinical metrics and skewed the weight towards member experience. Health plans will need to address matters such as how well members understand their benefits, the ease of the experience surrounding the use of benefits, and resolution of issues with paying for services—to name a f...

Tune in to Current Trends For Payers for a grounded conversation about the forces reshaping health insurance and government-sponsored health plans. Sponsored by HealthEdge, this podcast moves beyond surface-level news to examine the operational backbone required to navigate today's complex landscape. Each episode features direct dialogue with industry experts who understand that real progress hinges on the infrastructure behind the scenes. You'll hear specific discussions on practical areas like leveraging BPaaS and new technology, strengthening data security, and refining core administration processes. We also delve into the critical human elements of care management and member engagement, alongside the metrics that matter, including risk adjustment and HEDIS and Star quality measures. Whether it's strategies for start-up growth or adapting to regulatory shifts, the focus remains on actionable insights that can lead to better business outcomes and, fundamentally, a higher quality of care for members. This is a resource for professionals seeking a deeper understanding of the systems and trends that define success in the payer space.
Author: Language: en-us Episodes: 44

Current Trends For Payers
Podcast Episodes
Strategies For Reducing Gap and Chase Time Frames [not-audio_url] [/not-audio_url]

Duration: 17:11
“It’s essential to accelerate the speed and time for gaps to identify them faster and proactively.” In the context of risk adjustment gaps, there are two overarching goals—to identify and accurately predict member condit…
Digital Tactics For Member Engagement [not-audio_url] [/not-audio_url]

Duration: 10:34
“There’s a whole new range of possibilities for interacting with members through digital medium.” Marketing and communications in the Medicare Advantage space have evolved significantly in the past five years. Leaving be…
Next Generation Care Management Technology [not-audio_url] [/not-audio_url]

Duration: 21:15
"The only way to proactively identify and manage members with rising risk is by connecting care teams with real time data, analytics, and predictive models." In this episode, we explore the origins of care management, re…