Medicare at 50: Past, Present & Future

Since its inception on July 30,1965, millions of elderly and disabled Americans have been able to obtain medical care through Medicare. Before Medicare, almost half of all Americans 65 and older had no health insurance. Today that number has dropped to a staggering 2 percent.


The accomplishments for Medicare have been noteworthy.

MLTSS: Key to Caring for Duals

We all want to do it: Provide the best healthcare services for our members. For our vulnerable population, this can be complicated, if not near impossible to achieve, given the current healthcare issues at hand.

EHR Incentive Programs: Improving Access to Care

The 2014 Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs were developed to providefinancial incentives to eligible professionals, eligible hospitals, and Critical Access Hospitals (CAHs) to achieve meaningful use of certified EHR technology with the goal of improving patient care.  The programs worked to prompt healthcare providers to adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology.  In her May 18, 2015, 

At the Intersection of Exhausted and Impossible

Today, most employees and employers in all organizations struggle to do more with less…not just health plans.


Quality Ratings: No National Standard for MCOs…Yet

recent article noted five major changes in new Medicaid Managed Care rules, one pertaining to a quality ratings system. Many states have quality ratings for managed care plans, but currently there is no national standard.

Obamacare Reinsurance and Risk Adjustment, Year One.

The much-anticipated “Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2014 Benefit Year” has been released by the Centers for Medicare & Medicaid Services (CMS). A staggering 99.7% of Issuers were able to successfully submit data. The remaining 0.3% either did not set up an EDGE server or submitted data CMS could not use for risk adjustment calculations.  Considering the aggressive timeline Issuers were given, this completion percentage is quite remarkable.