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Unlock The Potential of Prospective Programs

Unlock The Potential of Prospective Programs

FromMedicare Advantage For Health Plans


Unlock The Potential of Prospective Programs

FromMedicare Advantage For Health Plans

ratings:
Length:
21 minutes
Released:
Feb 5, 2024
Format:
Podcast episode

Description

As more and more provider organizations enter into risk-sharing agreements, provider engagement programs are experiencing a surge in participation. Provider engagement programs improve the collaborative relationship between plans and providers to keep documentation up-to-date for CMS submission. It's essential for plans to offer a variety of delivery methods to suit the provider's practice. Some practices enjoy an in-person, on-site method to receive personalized guidance for education and to maximize documentation opportunities, while other practices enjoy an EMR-integrated solution for a highly efficient digital workflow. Providers with an already established process for responding to queries may prefer a remote option via fax. The important aspect of a healthy provider engagement program is not necessarily the delivery method but rather the timely and continuous communication between plans and providers to close gaps on addressable conditions. Tune in to discover the best practices for running a successful provider engagement program. About Our Guest:Michelle Calagaz is an expert in prospective risk adjustment programs specializing in provider engagement tactics. She has over 30 years of experience working in healthcare with a focus on Medicare Advantage initiatives and has an array of experience across risk adjustment, business operations, program implementation, product development, and client relations. 
Released:
Feb 5, 2024
Format:
Podcast episode

Titles in the series (24)

Insider insights and perspectives for healthcare executives of government-sponsored health plans. We’re talking to the experts about the unique operating infrastructure necessary for profitability and providing a best-in-class member experience. Topics include technology, data security, operations, health management, member engagement, risk adjustment, quality measures, start-up and growth tactics, legal and regulatory.