Wakely Wire
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Whitepapers, briefs, press releases and more
Falling Stars: Wakely Dissects the Decline in Medicare Advantage Star Ratings
Updated October 31, 2024 On October 10th, CMS publicly released the 2025 Medicare Part C and D Star Ratings. Wakely has quantified the significant decline in 2025 Star Ratings on Quality Bonus Payments, or QBPs, for 2026. The result of our analysis: somewhere between $4 and $5 billion less in 2026 QBPs. This whitepaper dissects ... Read more
Week in Washington 10/31/24
Medicare Negotiation Lawsuit The multiple lawsuits challenging implementation of the Inflation Reduction Act drug negotiations continue to wind their way through the court system. Oral arguments were heard yesterday at the Third Circuit Court. To date the government hasn’t lost a major hearing but the cases are ongoing. On the Campaign Trail Speaker Mike Johnson ... Read more
Events & More
Falling Stars: Who's Who in the 2025 Star Ratings
This webinar will cover the recently-released 2025 Star Ratings, including an analysis of the expected impact on 2025 Medicare payments. Attendees should expect to hear discussions of the latest performance and program changes, along with the resulting impact on the contract level star ratings. We’ll also dive into the dramatic increase in cutpoints and discuss what plans can expect over the next few years. Beyond cutpoints, we will cover other upcoming changes to the Star Rating program and discuss their potential impact on Medicare Advantage Organizations (MAO).
Mastering Star Performance: Analytics and Stratification for Success.
Wakely’s parent company, HMA, will also be hosting a webinar on November 13th at 12pm ET. This webinar will focus on how MA plans can optimize their Star Ratings using the HMA Stars Accelerator Playbook.
Newsworthy Findings
For People With Opioid Addiction, Medicaid ‘Unwinding’ Raises the Stakes
As of September, more than 25 million Americans — including 1.9 million Floridians — had lost Medicaid coverage since the expiration of federal covid-19 pandemic protections in March 2023 that had kept people continually enrolled.
‘Dreamers’ Can Enroll in ACA Plans This Year — But a Court Challenge Could Get in the Way
When open enrollment for the Affordable Care Act starts nationwide this week, children brought to the United States without immigration paperwork who have since qualified for the Deferred Action for Childhood Arrivals program will be eligible for the first time.
Humana Boosts 2024 Earnings Guidance Thanks to Medicare Advantage Member Retention
Despite the stronger membership, Humana doesn’t expect earnings growth next year due to significant investments the insurer plans to make to boost MA stars.
Change Healthcare Cyberattack Affected PHI of 100 Million
This represents a third of the population and makes the data breach the largest one known at a HIPAA-regulated entity.
Palliative Care in the ED Reduces Costs, Improves Patient Outcomes
The presence of an embedded palliative care practitioner in the emergency department can significantly improve patient outcomes and reduce costs.
Bonus Article
Boston Hospital Is Treating Food As Medicine With Its Own Rooftop Garden
Just for Fun
Math Joke:
Why is there no use in arguing with pi?
Prior Week
Q: Why should you never mention the number 288?
A: Because it’s “two” gross!
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