Peter Rodes’ Post

BIG PICTURE: Medicare Advantage stability appears to be the storyline. "CMS: Medicare Advantage, Part D premiums are stable for 2025 "(fiercehealthcare.com). But dig into the details on a market-by-market basis, and all sorts of change is happening! Humana is exiting 13 markets (affecting 500,000 beneficiaries) while Devoted is continuing its push for scale by offering 38% more plans. Take Arkansas, for instance, Devoted is coming into 18 new counties spearheaded with a Part B giveback. This will not be your average AEP. Plan Designs are revealed by CMS tomorrow! #medicareadvantage #healthworksai

📅 Significant news from CMS: The Hybrid measures have been delayed by one year. The voluntary periods are now July 1, 2023 – June 30, 2024 and July 1, 2024 – June 30, 2025. Furthermore, CMS will publicly post the claims portion of the hybrid measures for both 2023-2024 and 2024-2025. Stay updated on the latest healthcare developments and learn how to best prep for hybrid measure submission. 📈 More details: https://hubs.ly/Q02X0-3X0 #OPPSFinalRule #CMS #HybridMeasures #RegulatoryUpdates #Medisolv

Navigate the evolving healthcare landscape with proactive revenue cycle management strategies to ensure financial health & superior patient outcomes. Partner with experts like LBMC for guidance through regulatory shifts and compliance challenges. #HealthcareInnovation #PatientCare

Cost-Containment Expert Discusses Benefits ROI, PA Policies, Provider Friction: Amid concerns about utilization trends, a disappointing final rate notice and ongoing regulatory changes, “headwinds” has been the dominant buzz word in Medicare Advantage for months. To gain a better understanding of the cost-containment levers ... Read More #marketaccess #lifesciences #pbm

At a high level, how are you assisting Medicare Advantage insurers as they face multiple challenges? Executive Editor at MMIT (Managed Markets Insight & Technology), Lauren Flynn Kelly posed this question in a recent interview with AArete Managing Director Paul Schuhmacher. Follow the link to find out how AArete’s experts like Paul help Payers navigate PA policies, provider friction, and more! https://hubs.ly/Q02y7Yjm0 #AArete #CostManagement

Today, the importance of FHIR Standards is gaining significant attention in the healthcare IT community. Here's what they are: FHIR (Fast Healthcare Interoperability Resources) standards are a set of rules and specifications for exchanging electronic healthcare data. In simple terms, FHIR standards: - Enable secure and standardized data exchange between healthcare providers, payers, and patients - Facilitate seamless communication between different healthcare systems and applications - Empower patients to access and share their healthcare data with ease. By adopting FHIR standards, we can improve patient care, enhance patient empowerment, and increase efficiency in healthcare services. #FHIR #HealthcareInteroperability #DataExchange #PatientCare #HealthcareIT

Staying ahead of regulatory changes like the Medicare Part D update and CMS’s shift from V24 to V28 can be overwhelming. But it doesn’t have to be. With Curation Health - a Reveleer company's platform, we simplify the process by integrating real-time updates directly into clinical workflows. No more digging through endless data points—just clear, actionable insights that support compliance and improve patient outcomes. Our goal? Making the transition easier for providers and helping health plans optimize their performance. https://lnkd.in/e2fv-n2p #regulatorychanges #valuebasedcare #VBC

Missed our latest webinar with Becker's Healthcare? We've got you covered! Dive into the world of payer organizations enhancing Star Ratings and optimizing member care through strategic partnerships and innovative approaches. Catch up on all the insightful discussions from the session right here: https://bit.ly/3vL3FLb #PayerPerformance #StarRatings #WebinarRecap

📢 Join this FREE webinar! 🔑 SNF Value Based Purchasing: Strategies to Improve Your Medicare A Performance and Payment Rewards 🗓️ NOVEMBER 21ST 🕚 TIME: 11am PST / 1pm CST / 2pm EST 👉 🌐 RESERVE YOUR SPOT ⬇️ : https://lnkd.in/ePjkQFcU Attend to learn about the FY2025 changes to the SNF Value Based Purchasing Program. There were (4) four new measures were added in 2025, for a total of eight VBP measures. Your performance of these eight measures in #FY2025, will determine your #MedicareA payment rate in 2027! What you do NOW matters! ▶️ How the SNF Medicare A Value Based Purchasing program works ▶️ The eight VBP measures that affect Medicare A payment ▶️ VBP reports available to help track your performance ▶️ Practical Strategies to improve your performance and increase Med A payment SPEAKER: 🌟 Don't miss the chance to hear from Dena Finestone, EVP of Strategic Planning at Enhance Therapies, as she guides you through the roadmap of success in this evolving landscape. SPONSOR: Find out more about Enhance Therapies https://lnkd.in/eMqiPrKF This webinar is brought to you by Enhance Therapies, the management services organization of South Pacific Rehab and Rehab Advisors #healthcare #webinar #stayinformed 💡 H