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Flexibility is Key to High Value Medicare Advantage Benefit Design

In recent years, CMS has made dramatic changes to the regulation of Medicare health benefits.  In this blog we discuss the emphasis the agency has placed on flexibility.  Two January reports from Deft Research illuminate the value of flexibility in Medicare benefit design...
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Social Determinants of Health and Convenience ER Use

In this article, we focus on the use of the emergency room by some patients for non-emergency and routine medical care. We develop the term “Convenience ER Use” to refer to this...
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Dimensions of Social Determinants of Health

The health system, including insurers, care systems, and allied organizations wants to develop and improve population health management. Toward that end social data referred to as Social Determinants of Health (SDoH) have been identified as a source of information that helps system managers understand “the non-medical obstacles that prevent people from being as healthy as they can be.”  This is a good working definition of SDoH...
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Between Social Determinants of Health and Health Outcomes Lie Keys to Communication

Our analysis led to the development of five groups of people, based on how their responses to the domains described above clustered together.  Membership in one of the groups means that the individual’s responses demonstrated a pattern like the responses of other individuals in that group; they were substantially different from the responses of members of other groups...
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For Health Plans that want Competitive Star Ratings, Deeper Member Experience Insights are Needed

Medicare Advantage is the fastest growing line of health insurance. Member experience is its most important quality rating domain. And CAHPS is becoming the most important source of member experience metrics. Seeing these trends, many health insurers are turning to annual quality rating diagnostic and monthly tracking projects to understand how the interactions between members and health plans might affect future CAHPS survey results...
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CASE STUDY: Seizing the Medicare Advantage Opportunity with Conjoint Analysis

Medicare Advantage plans have emerged as a top opportunity for health insurers. Favorable regulations, and seniors’ increasing recognition of MA value have led most observers to forecast continuing enrollment growth for many years to come...
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