Healthcare IT Today February 22, 2023
There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees, operate on the cutting edge of health care and suffer serious problems in data collection and billing.
A recent article of mine explored how CMS is using AI to find suspicious payments that deserve investigation. This article looks at the problem from the other side. Here, we adopt a position sympathetic to the hurdles facing Medicare Advantage plans and look at how they are trying to improve the quality of data.
A bit of cynicism is deserved here. Consultants who offer services to healthcare providers often cite “improving the quality of...
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