Medication Therapy Management (MTM) services provide education, improve medication adherence and detect adverse drug events and can also help identify and address member concerns and empower them to self-manage their medications and health conditions. Since the Centers for Medicare and Medicaid Services (CMS) added the MTM Program Completion Rate for Comprehensive Medication Review (CMR) measure with a weight of 1 to Star Ratings in 2016, it now also has a direct impact on plan revenue. The average 2017 rating for this measure was 2.8 for PDP plans and 2.4 for MAPD plans—but like all Star Rating measures, this is a moving target. With the CY 2018 May program deadline around the corner, it’s time to explore the challenges associated with this measure, plus how you will reach and engage eligible members to improve completion rates.
This month you are likely finishing up your supplemental data source (SDS) collection and source code submission in order to meet the May deadlines. But have you considered the possible sources of valuable information that may already be available in your organization? Before you deploy that team of nurses to scour medical records and perform medical record reviews (MRRs), check with your risk team for home assessment medical record documentation derived from a prospective annual health assessment. CenseoHealth assessments meet the requirements for a compliant medical record and can close several HEDIS measures including:
It’s a new year. That means new data sets, budgets and opportunities for closing gaps in care and improving Star Rating scores and risk scores. With all of 2017 laid out in front of everyone, there’s a chance to move the needle and positively impact the members and patients of each healthcare delivery organization.
As 2016 comes to a close, we'd like to take this opportunity to thank our readers who regularly keep up with our blog, and welcome you if you're a new reader!
Adults age 65 and older are at higher risk for contracting contagious illnesses and diseases such as the flu, and can have a more difficult time rebounding. That’s why it’s especially important to communicate to health plan members ways they can stay happy and healthy during the busy holiday season.
Since only 49 percent of Medicare Advantage Part D active and rated plans in 2017 received 4 Stars or better for their 2017 overall rating, many are seeking ways to improve Part C and Part D measures that impact these scores.
In the summer of 2015, Janet Wood CPC, CRC, and Kat Mulligan CPC, CRC, saw the need for starting a local chapter of the American Academy of Professional Coders, an organization that provides certifications, training and continuing education for medical coders.
But even with access to several local chapters in Dallas and Fort Worth, the commute times to meetings became too much of a hassle.
Anyone age 65 and older can experience greater severity in symptoms and complications from influenza—and according to the Centers for Disease Control and Prevention, older adults accounted for roughly 60-80 percent of flu-related deaths in recent years.
The table is set, and the turkey is carved. Your family is all at the table—for most of us, that’s a rarity. So what will be the topic of conversation with the multiple generations sitting at your table for Thanksgiving Dinner? In honor of National Family Health History Day, consider using this opportunity to discuss the chronic conditions that affect or have affected your loved ones and relatives.
Diabetes impacts approximately 30 million people in the United States. More than a quarter of those individuals are 65 and older, making this a serious health concern for the elderly population. World Diabetes Day 2016 is meant to bring awareness to the vulnerable populations worldwide who battle diabetes every day.