The question has never been whether managed care organizations can improve care and outcomes for disadvantaged populations in Medicare. Instead it is how can plans improve care on a financially sound basis, and on that question the jury is still out. Medicare Advantage plans serving vulnerable populations (including Medicare-Medicaid dual eligibles, the chronically ill, and rural and inner-city residents where providers are in short supply) face a worsening financial climate as MA payment rates decline. But there could be changes coming, as CMS has agreed to consider whether duals status causes lower star quality ratings, and plans themselves develop innovative ways to improve their financial performance. Find out what moves CMS is likely to make and which strategies are likely to have the most bottom-line potential for health plans.
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