Market Alert | 09.20.19
Market Alert | 08.22.19
Encounter Data Quality: The Overlooked Risk Impacting Revenue & ComplianceDid you know that 60-85% of encounter data issues impacting the accuracy of regulatory submissions occur pre-submission for health plans? With the regulatory
Market Alert | 08.08.19
Heads Up, PBMs: New Reporting Requirements for Prescription Drug Coverage in 2020With the recent passage of The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act
Market Alert | 08.01.19
2018 ACA Risk Adjustment Transfer Payment Results: “Premium Stabilization Program” Beginning to StabilizeOn June 28th, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released the Affordable Care Act (“ACA”) Risk Adjustment
Market Alert | 07.01.19
Explore the 2018 ACA Risk Adjustment Transfer Payment ResultsOn June 28th, HHS released the Summary Report on Risk Adjustment Transfers for the 2018 Benefit Year. Explore an interactive dashboard on the high level results.
News | 05.14.19
Oak Street Health Partners with Pareto Intelligence to Improve Revenue AccuracyThe partnership’s initial successes have led to a continuation and expansion of services focused on a holistic approach to achieving complete and accurate revenue capture.
Market Alert | 04.27.19
Understanding the 2020 Medicare Advantage and Part D Rate Announcement & Final Call LetterIn April, the Centers for Medicare & Medicaid Services (CMS) released final policy and payment updates to the Medicare Advantage (MA) and Part D programs through the 2020 Rate Announcement and Final Call Letter. While there are many themes contained in the full document, one major takeaway stood out.
Market Alert | 04.09.19
2018 ACA Risk Adjustment Interim Report: Huh, Yeah, What is it Good For?CMS’ annual interim risk adjustment report provides many health plans with their first insights into the risk of their state market and their relative position. Though there are challenges to interpreting the results of this report, the answer to the question “what is it good for?” is certainly not “absolutely nothing.”
Market Alert | 02.19.19
Spotlight on the 2019 Medicare Advantage Annual Enrollment Period ResultsUsing our Pareto Spotlight solution, Pareto aggregated and analyzed the final Annual Enrollment Period (AEP) results data to understand changes in enrollment and the impact of 2019 product strategies.
Market Alert | 02.01.19