Risk Management for Health Plans – Part 3

In Part 2 of our Risk Management for Health Plans series, we provided a high-level understanding of how to approach risk management from a tactical perspective. This week we will provide you with a strategic framework to apply to your  program. The 5 Pillars of Risk Management Keep in mind, Risk Management is a continuous…

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Risk Management for Health Plans – Part 2

In Part 1 of our Risk Management for Health Plans series, we focused on risk culture. This week we will get more tactical and breakdown the operational approach to risk management. Organizational Approach to Identifying & Managing Risk The day-to-day operational approach to risk management requires people, processes, and systems for any organization to properly…

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Risk Management for Health Plans – Part 1

Recently, CODY® conducted, through our partnership with the Association for Community Affiliated Plans (ACAP), a webinar titled Identifying & Managing Risk. These are a few of the questions regarding risk management for health plans that we considered: How effective is your organization at identifying and managing risk within your health plan from an operational and…

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CMS Audit Updates—Proactive Steps to Ensure Readiness & Maintain Compliance

Success in any CMS audit depends on being prepared to ensure readiness and maintain compliance throughout the year. Taking proactive steps now to support future CMS audits will produce better results and experiences for health plans and create a greater level of confidence for participants. New Audit Protocols for CY2022 Earlier this year, CMS released…

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The Bridge — Volume 12

Madena™ and CODY® Merge to Expand Technology and Consulting Capabilities CODY® Acquires Madena Madena has been acquired by CODY®, a leading healthcare technology and consulting firm. The combined offerings and decades of industry expertise provide Medicare, Medicaid, and Commercial health plans an ‘end-to-end integrated solution’ previously unavailable in the marketplace. CODY® works with over 60…

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The Bridge — Volume 12

Madena™ and CODY® Merge to Expand Technology and Consulting Capabilities CODY® Acquires Madena Madena has been acquired by CODY®, leading healthcare technology and consulting firm. The combined offerings and decades of industry expertise provide Medicare, Medicaid, and Commercial health plans an ‘end-to-end integrated solution’ previously unavailable in the marketplace. CODY® works with over 60 government-funded,…

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The Bridge – Volume 11

CMS Important News Releases With a general election, massive increases in COVID-19 cases across the country, and many organizations focusing on the Annual Election Period, you may have missed these important CMS news releases. Advance Notice of Methodological Change for 2022 CMS will calculate 100% of the risk score using the 2020 CMSHCC model (vs.…

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