Managedhealthcareresources.com

Population Health Management Strategy

WEBHealth Plans must look for new patterns of emerging risks, changes in health status, opportunities to improve health literacy, and safety issues affecting health …

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URL: https://www.managedhealthcareresources.com/blog/PHM

MHR's Guide to Planning Your Model of Care for CY2026

WEBSNPs with a passing score can implement their SNP products in January 2026. Here is an example with estimated time frames. October 2024>NCQA’s Training …

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Managed Healthcare Resources NCQA Accreditation …

WEBManaged Healthcare Resources (MHR) builds partnerships throughout the entire process. MHR has been helping prepare clients across the United States prepare for and …

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NCQA HEALTH EQUITY ACCREDITATION ADDS VALUE TO HEALTH …

WEBNCQA HEALTH EQUITY ACCREDITATION ADDS VALUE TO HEALTH PLANS & MBHOs . Word count: 535. Estimated time to read: 3 minutes. NCQA has …

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HEALTH PLANS BENEFIT FROM USING NCQA PHM PREVALIDATED …

WEBHealth Plan. Managed Behavioral Healthcare Organization. Population Health Program. Organizations benefit the most from using vendors whose HIT …

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MHR Newsletter 2024_04

WEBDozens of Health Plans Ask CMS to Crack Down On Medicare Advantage Denials. Using a New Payment Model to Integrate Primary Care Into Specialty …

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MHR Newsletter 2024_01

WEBCMS Health Equity Conference. Bethesda, MD/Virtual; June 11-13, 2024 AHIP 2024 AHIP. Las Vegas, NV; August 9, 2024 MHR’s Client-Only Training – Save …

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MHR Newsletter 2024_02

WEBHealth Plans, MBHOs, Care Management Organizations, and CVOs are in the midst of reacting to mergers & acquisitions, new regulations, medical policies on new …

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About our Consultants

WEBErin Kafieh is a Registered Nurse with more than 26 years of experience in NCQA accreditation with all product lines. Her expertise includes file review standards for Utilization Management Denials and Appeals, …

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CREDENTIALING COMMITTEES

WEBHealth plans and MBHOs may already have this type of report in their QI or UM program evaluations or the Network Management access and availability reports. …

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HEALTH EQUITY ACCREDITATION: SHOULD YOU PURSUE IT

WEBYour documented processes must be in place six months prior to an Initial Survey. Three critical factors are within the HE Accreditation standards. You must have sufficient data …

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Is an M&A in Your Organization's Future

WEBFor health plans, it is Appendix 3, and for MBHOs, it is Appendix 4 of the 2024 standards. Instead of a MAC Survey, NCQA may evaluate NCQA-Accredited …

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MHR Newsletter 2023_13

WEBNCQA Health Equity Forum. Los Angeles, CA; March 12-14, 2024 2024 Medicare, Medicaid, Duals, & Commercial Market Forum AHIP. Baltimore, MD; April 2-3, …

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MHR Newsletter 2023_10

WEBIncome, Poverty, and Health Insurance Coverage: 2022 The US Census Bureau. Online News Conference 10 a.m. ET; September 27, 2023 Social Determinants …

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NCQA SYSTEM CONTROLS PROMOTE SYSTEM INTEGRITY

WEBNCQA standards on system controls apply to all organizations that perform credentialing, recredentialing, UM denials, and UM appeals for medical necessity and …

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Managed Healthcare Resources Blog

WEBAll Categories accreditation analysis cmsmodelofcare credentialing credentialingcommittee cvo delegation health equity health plans integrity leadership model of care ncqa ncqa …

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