Nov 15 2017 | Thought Leadership | By

Capitalizing on Comprehensive Care: Cultivating a Medicare Advantage Mindset

Author: Richard Jones, Chief Executive Officer of Essence Healthcare & Chief Corporate Development Officer, Lumeris

In response to the growing popularity of Medicare Advantage (MA) among consumers, the number of provider-sponsored MA plans is on the rise. Launching an MA plan offers health systems the potential to strengthen their bottom lines while acquiring the capabilities to manage the healthcare needs of beneficiaries.

However, the road to MA success is fraught with significant financial, operational and regulatory risk. Success requires executing well in several areas and involves many stakeholders both inside and outside the organization.

In this paper, you’ll learn the intricacies of launching a provider-sponsored Medicare Advantage plan, including:

  • The operational expertise in member acquisition, medical management, regulatory requirements, compliance and other areas needed for success.
  • How to establish comprehensive physician networks that meet network adequacy requirements.
  • Why complete and accurate coding and documentation are essential to optimizing MA plan performance.

You’ll also read about several organizations that are pioneering better, more efficient and more convenient care through Medicare Advantage.

Learn about the unique challenges and opportunities for health systems considering launching an MA plan, and why working with an operating partner offers a route to success. Read the full paper here.

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