Using Social Determinants of Health to Combat COVID-19
David Thompson,
Thrisha Oruganti,
In a COVID-19 landscape, can predictive analytics and social determinants of health help you better care for your population? Pareto answers this question using data.Read
Data Integrity: Medicare Advantage
Pareto’s Data Integrity solution identified the root cause of gaps in reported risk to focus remediation, resulting in $3 million in financial improvement opportunity for a 100,000-member MA plan.Read
Preventing RADV Audit Exposure Through Compliant Risk Documentation Processes
Brandon Solomon,
Jeff De Los Reyes,
Taking proactive measures to improve risk documentation accuracy prevents RADV exposure, or worse, potential litigation. What should health plans do?Read
Success of PPOs, OTC Coverage May Drive 2021 MA Offerings
Jason Montrie,
In this interview with AIS Health, hear strategies for incorporating lessons learned from 2020 into benefit designs before bids are due for 2021.Read
Deep Dive into Medicare Advantage Supplemental Benefits Trends from 2020 AEP
Brandon Solomon,
William Payne,
Using the 2020 AEP results, Pareto evaluated the year-over-year trends in supplemental benefit offerings prevalence and adoption across the Medicare Advantage market to help MA plans make more informed product decisions for 2021.Read
Data Integrity: ACA
Pareto’s Data Integrity solution identified the root cause of gaps in reported risk to focus remediation, resulting in $7.7 million in financial improvement opportunity for a 115,000-member ACA plan.Read
Analysis of the 2020 Medicare Advantage Annual Enrollment Period (AEP) Results
Pareto Intelligence,
Now that the dust has settled post-AEP, and CMS has released February monthly membership enrollment data, we have granular insight into the shifts in membership resulting from 2020 AEP.Read
Revenue and Payment Integrity
Our evaluation identified multiple improvement opportunities for this health plan, resulting in over $10 million in financial impact over the last 2 years, as well as a substantial risk score increase for both the MA and ACA markets.Read
Value-Based Reimbursement
A health system with 40,000 Medicare Advantage (MA) members across multiple payers engaged Pareto Intelligence to evaluate internal encounter processes as well as the submission accuracy of their payer partners resulting in a $4.7 million financial improvement impact.Read