Resource Library

Playbook for Success: Winning at CMS Star Ratings Medication Adherence Measures

Medication adherence measures play a critical role in a health plan’s ability to earn 4+ Stars – the coveted threshold which rewards payers with a higher proportion of premium dollars, quality-based bonuses, and opportunities to increase market share. Download our latest white paper to find out how RxAnte has transformed payers’ approaches to Star Ratings,…

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UPMC Health Plan and RxAnte co-host webinar on winning at CMS Star Ratings

Improving members’ med adherence is complex and difficult. Doing it while being measured against ever-increasing CMS Star Ratings is a next-level challenge. So how do health plans do it effectively? Learn how one successful plan discovered and implemented the key components of timing, targeting, effectiveness, and scale to win at medication adherence. Watch this webinar…

Prevalence and Cost of Unsafe Opioid Use in a Medicare Advantage Population

The policy and industry response to prescription opioid overutilization has focused on alerting payers and providers, and limiting patient access to these medications, when utilization patterns suggest overuse, fraud, or evidence of addiction. Authors: Joyce, Amie T; Ross, S. Michael; Kautz, Sharon R; Hamilton , Laurie S; Erxleben, Tori E; McKethan, Aaron N; Benner, Joshua…

RxAnte Perspective: Proposed CMS Medicaid and CHIP Rule Making

Recently, the Centers for Medicare and Medicaid Services (CMS) released proposed changes for Medicaid and Children’s Health Insurance Program (CHIP) managed care programs. This is CMS’s first update to the Medicaid managed care organization (MCO) regulations in over a decade. There have been many changes in the healthcare marketplace since the last MCO rule update…