Certifi.com

Transitioning to a State-Based Exchange: A Complete Guide

Once you’ve gotten buy-in from stakeholders, the next step in transitioning to a state-based exchange is vendor selection. Several states created a Request for Information (RFI) the year before they created a Request for Proposals (RFP). … See more

Actived: 6 days ago

URL: https://www.certifi.com/blog/transitioning-to-a-state-based-health-insurance-exchange/

Medicare Advantage: How 3 Health Plan Startups Fared

WebUnited and Centene saw strong market share growth, while Humana and Kaiser experienced the largest market share contraction. Finally, startup health plans …

Category: Health Go Health

2024 Medicare Advantage Star Ratings

WebIn 2024, just 5.69% of MA-PD plans earned a five-star rating. In 2022, the average MA-PD plan earned a 4.37-star rating. That declined to 4.14 in 2023 and …

Category: Health Go Health

Private Health Exchanges: Frequently Asked Questions

WebA private exchange is an online store or marketplace that enables employees or retirees to shop for benefits from a selection of plans. The exchange will often include …

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NPS for Health Insurers

WebThe average health insurer achieved an NPS score of 27. Bright Health – In their IPO filing, Bright Health indicated their NeueHealth Clinics had an NPS score of 78. …

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What is Network Adequacy in Healthcare

WebNetwork adequacy generally refers to a health plan’s ability to provide reasonable access to in-network healthcare to a plan’s members. Generally, health …

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The Future of Medicare Advantage Star Ratings

WebThese measures have recently increased, going from a 1.5 weight, to a 2.0 weight in 2021 and up to a 4.0 weight in 2023. That 4.0 weight translates to the patient …

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Health Insurance Member Engagement: 5 Tips to a Better Experience

WebHealth insurance member engagement starts with your member services team. That team is likely the most visible aspect of your organization to your members. …

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A Guide to IaaS, PaaS and SaaS for Health Insurers

WebA Guide to IaaS, PaaS and SaaS for Health Insurers. 2021-05-17. Software delivery has changed considerably in the past two decades. Though on-premise …

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Transitioning to an SBM: 5 Benefits of State-Based Exchanges

WebThis year, New Jersey and Pennsylvania made the transition from Federally Facilitated Marketplaces (FFM) to State-based Marketplaces (SBMs). They joined 13 …

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Group Benefit Billing: Why Benefits Administrators and

WebIn a world of nearly instantaneous money transfers, digitized enrollment data, and complex insurer core admin systems, it’s surprising that benefits billing causes …

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Medicaid PHE: New CMS Return to Normal Operation Guidance

Web2022-03-28. In early March, the Center for Medicare and Medicaid Services released SHO#22-001 to help states deal with the conclusion of the Medicaid Public Health …

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Health Insurance Data Analytics: 5 Ways Health Plans Leverage

WebOr, an older member may prefer office visits and phone calls, while a younger member may prefer telehealth visits and text reminders. Health plans can …

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Health Insurance Member Journey Mapping

WebMember journey maps help health insurers better understand member interactions. They can provide insights into what members think of health insurance …

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An Analysis of 2022 Preliminary ACA Premium Rates

WebAn Analysis of 2022 Preliminary ACA Premium Rates. 2021-09-06. The Affordable Care Act (ACA) requires health insurers who participate in the ACA …

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7 Examples of Great State Health Insurance Exchange Marketing

Web7 Examples of Great State Health Insurance Exchange Marketing Campaigns. 2020-08-24. Growing enrollment in a state health insurance exchange is a …

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2022 Health Insurance Industry Outlook: Indications From Four

Web2022 Health Insurance Industry Outlook: Indications From Four Annual Earnings Reports. 2022-02-21. Last month, we examined what recent payer investor meetings tell us about …

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Best Practices for Accurate Health Plan Premium Billing

WebBest Practices for Accurate Health Plan Premium Billing. 2023-07-24. Inaccurate billing practices can negatively impact a health plan’s brand and bottom line. …

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