Navigating Risk Adjustment in the V28 Era
Risk-bearing entities such as IPAs, MSOs, and health plans — especially those operating in the Medicare Advantage space — are facing unprecedented...
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Bloom Value
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Exploring the Realities of Prior Authorization in Our Healthcare System
Life has a way of presenting us with stories that leave an indelible mark on our hearts. Recently, I had...
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The CMS ACCESS Model Is Rewriting the Rules of Chronic Care.Are Healthcare Organizations Ready to Execute?
Chronic disease is not a new problem in Medicare — but it is a problem that is persistent, expensive, and...
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Beyond Rates: What the Medicare Advantage Proposed Rule Means for Risk Adjustment and Star Performance
When the Centers for Medicare & Medicaid Services(CMS) released its January 26 Medicare Advantage Proposed Rule 2027, most attention went straight...
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Reading the Direction Beneath the CMS Advance Notice: Strategic Signals for Medicare Advantage Organizations
Each year, Medicare Advantage organizations recalibrate when the latest guidance arrives from the Centers for Medicare & Medicaid Services (CMS). In early...
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The UnitedHealth Probes: A Wake-Up Call for Medicare Advantage
By Arun Hampapur, PhD – Co-Founder & CEO, Bloom Value; Fellow, IEEE Disclaimer: This article was originally published in Health...
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Defensible by Design: The New Gold Standard in Risk Adjustment
Introduction: Defensibility in the Spotlight Recent headlines involving UnitedHealth’s Medicare Advantage practices have brought one word to the forefront of...
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Data-Driven Work Cultures: How to Effectively Leverage Data
As part of our series “How To Effectively Leverage Data To Take Your Company To The Next Level”, I had...
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