RISE 2023
“Major payment and regulatory changes in Part C and D will require that MA plans balance benefits and enhancing patient experience with compliance.”
Avalere expert Sean Creighton will moderate a panel discussion on topics such as the Advance Notice, RADV, and policy and technology rule updates and their implications for Medicare Advantage (MA) and Part D.
Regulatory Review for 2023
Tuesday, March 7, at 10 AM
Meet Our
Experts
Managing Director, Policy
Expertise: Medicare Advantage, Part D reform, Risk adjustment and RADV, Quality and utilization analysis
Managing Director, Policy
Expertise: Medicare Part D, Medicare Advantage, IRA implementation, Affordable Care Act, Federal drug pricing policies, regulatory process, risk adjustment
Senior Consultant, Policy
Expertise: Affordable Care Act, commercial plans, insurance bidding and rate setting, Medicaid, Medicare Advantage, Medigap, operations and strategy, patient perspective, risk adjustment
Consultant II, Policy
Expertise: Medicaid, Medicare Advantage, risk adjustment, strategy development, gap assessments, compliance reviews, operational improvement initiatives
Our experts will be available to discuss priority topics, such as:
Impacts of the RADV Final Rule
The Centers for Medicare & Medicaid Services (CMS) released the final MA risk-adjustment data validation (RADV) rule on January 30. The final rule sets future RADV policy and creates uncertainty for MA plans. Avalere is well positioned to provide industry perspectives on the final rule and to help plans mitigate risks posed by RADV audits and operational challenges posed by the rule.
Advance Notice Policies
On February 1, CMS released the 2024 MA and Part D Advance Notice. Plans are required to submit comments by March 6, 2023. The proposed changes have major implications to MA plan payment and long-term strategy. Our policy and health plan operations experts support clients in navigating these policy changes to maximize quality and reimbursement in MA and Part D.
Inflation Reduction Act (IRA) Implications
Avalere’s experts can help clients understand how implementation of the IRA is impacting payment rates, plan bids, and beneficiary out-of-pocket costs, and forecast the likely impact on formulary negotiations.
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Insights
We anticipate and identify today’s challenges, opportunities, and top trends to watch.
