She contains a established track record of driving compliance with NCQA requirements and optimizing Health care supply throughout diverse sectors, which includes Medicare, business ACA, and Medicaid.
️ MA bids for 2026 – due June two ⏳With numerous going parts, overall health plans and suppliers may have a brief runway to regulate to modifications — Placing a strain on means. ⏳ ATTAC Consulting is ready to assistance We could rapidly deploy our specialist service provider network administration team to guidance:
Lynn has designed and supported a variety of Group accessibility-to-care initiatives. She has made and executed social determinants of wellbeing applications and it has worked throughout membership populations.
This includes analysis of provider access and adequacy compliance plus the similar regulatory filings.
- John Barkley - Fantastic way to lead the panels and dropping some knowledge to many on bringing companies and payers alongside one another and seller oversight.
Prior to signing up for ACG, Jon served as director of possibility adjustment to get a multi-condition regional overall health approach that presented ACA /MA and Medicaid products and solutions, together with serving as regional supervisor for possibility adjustment in a nationwide health and fitness approach.
When was the final time you evaluated your HHS-RADV auditor? If it’s been a several years, you should know the landscape has evolved with new equipment and refined approaches which will make your once-a-year audit far more effective and impactful. ✅ ATTAC’s chase tactic decreases the volume of charts needed to validate HCCs. Our purchasers frequently notify us we request fifty percent the charts that other auditors do—though nonetheless providing validation results previously mentioned the countrywide regular. Despite having fewer charts, our coding technique has triggered a mean 10% boost in freshly identified HCCs —perhaps positively impacting possibility settlement.
Shared my vision for reversing Serious disease, integrating eco-procedure amongst Payers & Vendors and unlocking the power of Price-Based mostly-care products including RA, High-quality and so on. in U.S Health care along with some simple strategies and ideas to my market colleagues about ways to get PROACTIVE on the third Annual RA #Innovation Discussion board in Dallas. Strategic Alternatives Network ✳️ It truly is clear immediately after current pent up stress with the current point out of Persistent disorder, Prior Auth frustrations, higher cost of treatment and While using the administration transform, its a pivotal moment for all. #️⃣ It really is more significant to appear over and above The existing lens of KPIs of Danger Adjustment, STAR and worth dependent treatment general performance. Let us keep ourself accountable to each other on enhancing actual overall health results.
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Laurie is an element of ACG’s medical pharmacy apply group serving all software segments. She has extensive experience in scientific and operational management of pharmaceutical companies medicare consulting in a complete scope of Health care environments, like Medicare wellness courses, acute treatment and LTC arenas. Her multi-business know-how has provided integrated medical and operational strategic preparing, pharmacy community oversight, PBM oversight, pharmaceutical contract analysis and negotiation, and procedure reengineering to improve margin and compliance.
In collaboration with many departments, Justin produced and carried out corrective steps and extensive systems that strengthened organizational alignment. His strategic tactic extended to controlling jobs connected with regulatory disclosures and enforcement steps, accreditation, and certification.
Carmen is really a member of ACG’s Wellness System Functions and Government Plans Follow Groups. She presents shoppers aid in the event of effective internal auditing and downstream monitoring systems, together with offers operational knowledge inside the regions of enrollment and top quality billing (Specially MA and Component D), appeals and grievance administration, HEDIS reporting and administration of exterior audits.
At ACG, we’re captivated with our business and captivated with obtaining it suitable. We’re happy with our popularity among the business leaders to complete detailed operational analyses also to structure and deliver rock-stable stop-to-conclude solutions.
Darlene is a member of ACG’s Governing administration Plans Observe Group. She brings broad skills in organizational development and compliance management while in the Medicare and Medicaid arenas. For more than a dozen years, she has held senior legal and compliance roles inside the insurance coverage and managed care industries, where she has led routines as varied as wellness prepare get started-up, management of JCAHO and NCQA accreditation, condition and CMS regulatory oversight audits, managed line obligation for grievances and appeals, revenue agent oversight and market place carry out together with organization procedures and plan for company document retention. She has Earlier worked for Centene Corporation, AmeriGroup and United Healthcare.