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Feb 17, 2019

Is your PBM competing with you?

The past few years have been full of upheaval in the healthcare industry with mergers and acquisitions involving pharmacy benefit management (PBM) companies.

Jan 30, 2019

From insights to interventions: How to impact medication nonadherence

When patients don't take their medication as prescribed, it can lead to adverse health outcomes and increased costs. Alarmingly, 50% of patients are nonadherent at any given time1 causing up to $300 billion in waste per year.

Nov 1, 2018

DST Health Solutions named an IDC MarketScape Major Player

We’re pleased to share some good news:  SS&C’s DST Health Solutions was named as a Major Player in the IDC MarketScape: U.S. Population Health Analytics 2018 Vendor Assessment.

Oct 22, 2018

Do you have a comprehensive and effective risk adjustment program?

Many health plans focus on sweep dates and code capture while working in some prospective outreach for members, but are you optimizing your Risk Adjustment (RA) activities and tools to improve coding documentation and data submissions throughout the entire year? If not, you should be!

Aug 23, 2018

Two-step strategy for capital generation and plan modernization

Breaking free of the chicken-egg conundrum

In May 2018, America’s Health Insurance Plans (AHIP) published an infographic showing just 2.3% net profitability for commercial health plans.1 As I travel around the country speaking to plan executives, I can confirm just how real these narrow margins are, particularly for small-to-medium insurance companies. 

Aug 1, 2018

HEDISĀ® Guide 2019: opioid measures

The opioid epidemic is an urgent public health issue. Approximately 11.5 million people misuse prescription opioids each year, and the most recent data from the Centers for Disease Control and Prevention (CDC) indicates opioids were involved in 42,249 deaths in 2016. An analysis from CDC shows the overdose epidemic is spreading geographically and increasing across demographic groups.

Jul 11, 2018

How Medicare Part D plans can help combat the opioid epidemic

The prescription opioid epidemic in the U.S. is an urgent and growing public health crisis. With opioid addiction, overdoses, and deaths at unprecedented levels, a comprehensive and multi-pronged strategy is needed to combat this epidemic.

Apr 19, 2018

Medicare Advantage: changes ahead for risk adjustment and star ratings

On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 Call Letter and simultaneously released the Final Rule. Medicare Advantage plans have a great deal of information to digest in these major policy updates. Among the many changes, CMS continues to progressively adjust regulations and the financial impact related to the risk adjustment and Star Ratings programs.

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