Keeping up with rule and policy changes from the CMS is just part of life for MAPD plans. Recently, however, two in particular are signaling a shift to in the industry: CMS-4180-P and CMS-4185-P. Should these rules become final, MAPD plans and their beneficiaries will notice substantial changes. Here’s what health plan leadership needs to know.

Medicare Advantage Part D (MAPD) health plans inevitably have problems with scale when it comes to quality measure programs and strategic initiatives. Resources may be spread thin and funding may be challenging to acquire. Here are some places to start making your quality measure programs scalable.

Medicare Advantage plans need optimized adherence strategies to see rewards in the Star Ratings program. Success requires plans to make the most of medications, and that means understanding the intricate nature of their member population’s behaviors.

This year, sharp cut point increases for MAPD plans have created a steeper quality measures scale than in years past. If you’re feeling the sense of urgency to optimize your med adherence strategy – we understand. Here are some places to start.

For Medicare Advantage plans, value-based care is a double-edged sword. It can make it easier to grasp the importance of members’ needs. But it can create heightened sensitivity to the pressures of quality measures. We find that it helps to take a step back when looking at costs and quality.

Each year, cut points are announced in the fall and Medicare Advantage Part D (MAPD) plans anxiously anticipate their impact on Star Ratings. We interviewed our vice president of client services, Kerri Petrin, to find out what tips, tricks, and advice she gives to health plans in times like these.

Although there is some value in using trends from previous years to inform strategy, it misses the mark when it comes to improving adherence rates. To help plans inform planning and drive improvement, we take a closer look at comparing retrospective vs. prospective strategies.