Managed Healthcare Executive January 25, 2022
Adam Higman, DHA, FACHE

A look inside six trends that will shape and influence care, planning and performance over the next year for health plans.

Value, quality, and experience topped health plan members’ wish lists in 2021, amid a still-uncertain care environment. In 2022, nearly two years into the pandemic, these priorities remain, but but the pressure has intensified.

Health plans will be expected to deliver on promises, while facing monumental challenges—a turbulent economy, a higher threshold for achieving an “exceptional” Star Rating status, and hospitalization surges with the omicron variant. Additionally, the CMS increased its cut points for achieving the 4.0-star benchmark, while eliminating the pandemic-based grace period, which included modifications due to COVID-19, that boosted many health plans’ Star Ratings in calendar...

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Topics: Insurance, Patient / Consumer, Payer, Provider, Trends
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