Those who are beneficiaries within the Medicare system will have a new chance to take the opportunity to become involved with either or both the Medicare Advantage, as well as the Medicare Part D plan. There are certain terms and limitations to the new enrollment period; however it makes the switch more available and easier [...]

Hierarchical condition categories, commonly referred to as HCCs are a large part of the success of Medicare plans such as the part C Medicare Advantage plan. These categories are used to assign a certain monetary number on specific illnesses and the likely amount it will cost to care for a patient suffering from these illnesses. [...]

There are a number of different ways that the government is trying to improve the current health care system, and one of the ideas on the table is that of a Pay for Performance system rather than the current pay for services system that is most commonly used. There are a number of suspected benefits [...]

It was back in 2008 when the Center for Medicare and Medicaid initiated their rating program for nursing homes across the nation. The “Five Star” rating program has received much criticism from nursing homes on how they measure the quality of care provided by the facilities. One of the main criticisms is that the rating [...]

A recent analysis that was published by the Alavare Health organization, which serves as a health care consultant, shows a drastically different and varying set of extra benefits for beneficiaries of the Medicare advantage program across the country. The report shows that the differences state by state of extra benefits received varies from no extra [...]

The management of those individuals with chronic illnesses accounts for a large portion of the cost incurred within our health care system. This is one of the reasons why chronic care management has had such an emphasis put on its improvement and implementation across the country. Chronic care management focuses on the overall care and [...]

As the health care system within our country continues to strive for improvement, on area that is being focused on is that of case management along with disease, population and utilization management. The goals of case management, similar to those of care and disease management, is to focus on the well-being of the patient both [...]

Recently the URAC, which is the leading organization for health care education and accreditation, released the new standards as well as performance measures that determine their disease management accreditation program. The organization’s revisions and new standards match the current industry’s trends while at the same time meeting the new regulations placed by the government through [...]

As it becomes more and more clear that our health care system needs a boost of improvement, NextGen Healthcare Information Systems has announced a number of programs aimed at improving patient care through collaborative efforts. The company has created a variety of programs, services and products that could play a main role in supporting many [...]

One of the big aspects of the newly vamped health care system that was implemented through Obamacare was the creation of Accountable Care Organizations, or ACOs, alongside the Medicare Shared Savings Programs. As the second anniversary of the establishment of ObamaCare approaches, the success of the program has been called into question by many of [...]