“In a dynamic market, health plans must rely on data-driven strategies that align with policy requirements and patient needs.”
Position for Success
Our team of health plan experts combines first-hand industry experience, unique policy perspective, and access to unmatched data and analytics capabilities. Count on us to help you evaluate and manage risk, determine and optimize provider partnerships, expand into new business lines and markets, and prepare for future changes that will impact your business.
Improve Financial Performance: Thoroughly evaluating your risk and quality performance, we perform third-party, end-to-end assessment encounter data system (EDS) submission to identify opportunities to improve your risk score accuracy. We also identify and improve factors that cause low Stars performance, including supporting the appeals process.
Optimize Provider Networks: Gain transparency into provider performance in new markets and within your existing network. Our MORE2 Registry® combines Commercial, Managed Medicaid, and Medicare Advantage data. Analyzing this unique data from the lens of our government program and value-based provider arrangement expertise, we can optimize your provider network for growth and profitability.
Achieve Program Compliance & Operational Effectiveness: Transform operations while maintaining program compliance with our deep policy expertise and hands-on evaluation of your operational capabilities and gaps. Confidently expand into new markets and lines of business, considering the most important drivers of compliance and profitability.
Define Strategic Priorities: Develop a practical strategy with our highly collaborative approach facilitating leadership retreats and cross-functional work groups to understand the impacts. We work closely with every stakeholder to identify realistic steps and get you from here to there.