Category Archives: Medicare/Medicaid

Health Risk Assessments (HRAs) are a foundational element of care management for Medicare Advantage plans, particularly Dual Eligible Special Needs Plans (D-SNPs). However, an HRA is only as valuable as what you do with it. HRA completion is just the beginning for plans serving the nation’s most medically and socially complex members —...

Navigating the healthcare landscape is becoming increasingly complex, especially for individuals eligible for both Medicare and Medicaid. As policymakers seek ways to streamline processes and improve care coordination, a new proposed rule could be a game changer for dual-eligible plans. This proposal aims to simplify health risk assessments (HRAs), reducing administrative burdens while enhancing the...

Many Medicaid departments have issued state-specific standardized health risk assessments and require contracted MCO plans to assess newly enrolled members within 90 days of enrollment and in some cases annually thereafter. In addition to the burden of data collection, state Medicaid departments also require that assessment results are submitted on a periodic basis using defined file...

The Centers for Medicare and Medicaid Services (CMS) requires a health risk assessment to be included in the Annual Wellness Visit. The purpose of the Medicare health assessment is to identify heath needs and risk factors so beneficiaries can be directed to appropriate care, ultimately improving outcomes and reducing costs. The Center for Disease Control and...

Starting July 1, 2017 Medicaid and Children’s Health Insurance Program (CHIP) plans are required to make their best effort to conduct a health risk assessment within 90 days of enrollment for all new enrollees. Many health plan clients already use ConXus Profile Health Assessment for Medicaid in both adult and pediatric populations. We deliver secure,...