When the Medicare Advantage community received an ‘earlier than normal’ CMS Advanced Payment Letter/Part I Draft Release on Dec. 27, 2017, plan leaders were justifiably apprehensive about preparing for these sweeping, complex changes.
By Jay Baker, Senior Vice President, Quality and Risk Adjustment Solutions, Advantmed, LLC
Early release of the draft and a 60-day comment period required for these changes to the Medicare Advantage (MA) model is sending warning signals to MA plans. This is a real break from the normal cadence which is a signal to leaders that they should begin the process of marshalling the expertise and experience needed to prepare for this anticipated, complicated transformation.
While this is a draft, with subsequent releases from CMS expected in February and April that will refine what is implemented, it is evident that serial changes are underway. To assist MA plans that face this new complex regulatory environment, and deal with the reality of what needs to be accomplished in a very short timeframe, the following highlights provide a starting point for consideration. The importance of these discussions cannot be over-emphasized — financial and clinical adjustments will affect operational processes that impact plan performance, patient care and compliance. [Read more…]