I agree that there are still systemic issues with CMS using encounter data for risk adjustment, however… MA plans have to get better at fully and accurately submitting these data!  These submissions are the future in creating better outcomes and better health delivery. 

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10.12.18 07:27 AM - Comment(s)
A Day in the Life of the Encounter Manager

If you manage encounter data for a health plan, you probably have had an interaction like this before. You are working away and an email pops up in your inbox from your contact at the state agency. It says something along the lines of, "We are seeing so...

09.12.18 07:39 PM - Comment(s)

CMS has proposed new rules regarding Medicaid Managed Care, the first change in over a decade.  These rules cover a very broad range of changes and functions within Medicaid Managed Care.  Here we will review impacts specifically to Encounter Data Management operations and discuss what org...

09.12.18 06:11 PM - Comment(s)
Just like a star athlete, your encounter data require a healthy diet to achieve their maximum potential. This diet being the data that feeds your Medicaid encounter data and Medicare EDPS processes. As the old IT saying goes, garbage in, garbage out.

So let’s take a look at the encounter data “food g...
09.12.18 12:20 PM - Comment(s)
While I recently published an article discussing the seriousness of attestation ( Article here), we believe it is important enough to restate the crux of it again.

Since CMS made changes to the Medicaid Managed Care rules, there has never been “sharper teeth" in the CMS requirement of the States...
21.09.17 06:21 PM - Comment(s)
THE TOP 2 “MUST ASK” QUESTIONS FOR HEALTH PLAN CEOs & CFOs              
1.      Are you the CEO or CFO for a health plan with responsibility for encounter da...
21.09.17 06:19 PM - Comment(s)