Center of Excellence, Healthcare
Subject Matter Expert
Star rating is not only about compliance or a way for the Center of Medicare and Medicaid Services (CMS) to assess the quality of health plan contracts based on their performance – there’s a lot more to it!
Join our domain experts, Prashant Budania and Priya Sharma, sharing insights on how bad rating can affect your potential bonuses and can lead to loss of enrollees at the same time. And, how a health plan, like you, with a 4+ ratings stands to benefit directly in multiple ways that in effect act like a virtuous circle, leading to revenue growth. This virtuous circle is a multiplying combination of rebates, bonuses, additional quality improvement funding, the support from CMS on outreach, and an overall impact on enrolments and revenue.
Key Topics to be Discussed
- The scope of star ratings and its various parameters
- Why you must analyze your star ratings, and understand where is it hurting you the most?
- Why you must define a holistic, long-term platform strategy, and identify your process requirements?
- Benefits of 5-star ratings
- Why you must care about complaints, appeals & grievances (CAG) processes?
- How Newgen can help you streamline your CAG process and overcome operational inefficiencies
Who Should Attend?
- Healthcare payer CIOs
- Compliance analysts
- Compliance & regulatory officers
- Legal teams & procurement leaders
- Process & enterprise architects