Checklist
5 Steps for a Successful SNP Model of Care Submission
The Model of Care (MOC) must be built on evidence-based practices, must demonstrate your health plan’s ability to provide high-quality healthcare services to vulnerable populations, and must describe your approach to care coordination, member engagement, and other key areas. Achieve smooth SNP MOC preparation, submission, and approval using a handy checklist.
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Blog
Best Practices for Submitting Your SNP Model of Care
If your organization is preparing for annual Model of Care submission, it’s crucial that your team accurately interprets regulatory requirements, prepares well in advance, undergoes training and education, and understands the operational aspects of running a Special Needs Plan (SNP).
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Blog
5 Strategies for Streamlining Prior Authorization in Managed Care
While prior authorization (PA) helps improve quality with cost control measures, it often creates administrative burden and delays for providers. To address these concerns and optimize care delivery, managed care organizations must streamline the PA process.
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Guides
Population Health Management Guide for Health Plans
Targeted population health management is essential to manage member risk and provide integrated, coordinated care that enhances member engagement, health outcomes, and financial incentives and rewards.
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Case Studies
New Benefit Design & Implementation
Applied Behavioral Analysis (ABA) therapy health benefits are essential additions to health plans, as this therapy can improve and enhance the lives of the members and their families in addition to mitigating costly misaligned services.
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Blog
Breaking Down the Complexities of Behavioral Health
The United States spends extravagantly on healthcare, representing approximately 18 percent of the nation’s economy—nearly double what other developed countries spend—but despite what the United States spends on healthcare, we have worse health outcomes compared to other industrialized nations.
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