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Improving utilization management within your Medicare plan can be a tall order. With so many factors that impact it, it can seem like a moving target that requires agility to achieve. However, impleme
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Social barriers may be the most challenging aspect of supporting members in their health journeys. Experts agree that these social barriers, or social determinants of health (SDOH), influence as much
The modern perspective of health care has shifted dramatically to focus on the whole person and to integrate physical and behavioral. Behavioral health is just as important as physical to any individu
Improving Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores is challenging for any Medicare or Medicaid plan. Moving the needle on these scores depends on engagement, perception
Is your health plan struggling with member retention? Your members have a choice, and losing them can impact your plan in many ways. It’s best to be as proactive as possible, and the most important as
Member engagement has been a priority for Medicare and Medicaid plans for years. The strategies used to improve it have had to adapt to changing times. The pandemic, greater adoption of digital channe
Curbing low-value, unnecessary Medicare spending is a goal of every plan. However, because so many factors influence spending, achieving cost reduction can be challenging. When plans look at the cause
The pursuit of cost containment in health care never waivers. Medicare and Medicaid plans leverage various strategies, resources and tools to improve the quality of care while reducing costs. Even wit
The health outcomes of your members depend on many factors. As a Medicare plan, you may only have direct control of some of those factors. Although you can provide members with resources and access to
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