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Pathways to Success MSSP final rule: Financial benchmark22 February 2019 - By Jill S. Herbold and Cory Gusland and Charlie Mills and Matthew J. Kramer - Article

This paper discusses the changes to the financial benchmark methodology that measures the gross savings or losses of an accountable care organization under the Medicare Shared Savings Program.

Pathways to Success MSSP final rule: Key revisions to the proposed rule07 January 2019 - By Noah Champagne and Charlie Mills and Jason Karcher - Article

This paper summarizes the key provisions of the final rule for the 2019 Medicare Shared Savings Program and highlights differences from the Centers for Medicare and Medicaid Services’s August proposal.

Pathways to Success: MSSP proposed rule: Financial benchmark28 August 2018 - By Jill S. Herbold and Cory Gusland and Charlie Mills - Article

This paper discusses “Pathways to Success” and the important implications in store for Medicare accountable care organizations.

Pathways to Success: MSSP proposed regulation: Summary white paper20 August 2018 - By Colleen Norris and Cory Gusland and Charlie Mills and Hugh Larson - Article

This paper provides a summary of the Centers for Medicare and Medicaid Services’ sweeping proposed regulations that will significantly change the Medicare Shared Savings Program.

Medicare Advantage’s transition from RAPS to EDS risk scores: 2017 impact09 February 2018 - By Deana Bell and David Koenig and Charlie Mills - Article

In 2017, many changes came to Medicare Advantage risk adjustment as the transition continued from Risk Adjustment Processing System data to Encounter Data System data.

Milliman RBRVS for Hospitals27 April 2017 - By William J. Fox and Edward Jhu and Charlie Mills and Kevin Frodsham - Article

The Milliman RBRVS for Hospitals™ Fee Schedule provides a simple solution for comparing hospital contractual allowed amounts, billed charge master levels, relative efficiency, and patient mix differences.

MACRA and Medicare Advantage plans: Synergies and potential opportunities21 February 2017 - By Christopher Kunkel and Drew Osborne and Lynn F. Dong and Michael J. Polakowski and Noah Champagne and Charlie Mills - Article

While MACRA primarily affects Part B clinicians, there are numerous implications, synergies, and opportunities for Medicare Advantage plans.

Impact of the transition from RAPS to EDS on Medicare Advantage risk scores13 January 2017 - By Deana Bell and David Koenig and Charlie Mills - Article

The transition to Encounter Data System-based risk scores will have a significant effect on Medicare Advantage organizations in payment year 2016 and future years.

Provider reimbursement analytics30 November 2016 - By David C. Lewis and Charlie Mills - Article

This paper explores different claims-based approaches for evaluating provider reimbursement.

Early thoughts on Medicare Shared Savings Program (MSSP) Track 1+08 November 2016 - By Charlie Mills and Christopher Kunkel and Colleen Norris and Noah Champagne - Article

CMS Final Rules for MACRA give glimpse of MSSP Track 1+ details.


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