Melissa Newton Smith’s Post

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Government Programs Advisor & Consulting Leader

⏰ The clock is ticking! With 25% of the measurement period for #CMS inaugural application of the #MedicareAdvantage #HealthEquityIndex already gone, many plans are still in neutral, struggling to determine where to begin and how to justify activities and investments. Remember: decision-making isn’t about finding the elusive “best” strategy. It’s about making informed, impactful choices that drive results. Too often, the #HEI has been handed off to the #StarRatings team. But here’s the truth: the #Stars value of the HEI should be the result of smart decisions across all departments, not a stand-alone task. We've been advocating for #MA plans to integrate the HEI, along with the Star measures that drive its success, to be the measurement of the organization’s broader #Compliance, Provider Network and Clinical Quality evolution needed to adhere to the #OCR May Nondiscrimination FR, CMS’s May #Medicaid FR, and the D-SNP Alignment elements of the 2025 MA FR. ❓ Will it be simple? No. ❓ Will it be the fastest way to the immediate-term HEI Math Path? Maybe. ❓ Is it essential? Absolutely. There simply isn’t enough topline revenue for MA plans to continue tackling new rules individually or in silos, especially with #RiskAdjustment V28 changes. These new regulations demand thoughtful, intentional, deep work so that strategies and tactics are sustainable and profitable. We crafted an innovative #QualityImprovement model to guide MA plan evolution and Stars success using Reality-based Leadership Principles. Our team has capacity to launch 3 more clients on this unique, year-long Stars Improvement journey in Q4. If you’re ready to transform your approach and achieve sustainable success, send me a message.  ⭐ ⭐ ⭐ ⭐ ⭐

Helen Liu

Vice President of Pharmacy Operations at ATRIO Health Plans

2w

Great information: thank you for sharing

Brendan Generelli

Stars and Quality Program Manager

2w

I love that “Stay in Joy or Go in Peace” quote, Melissa. As you know, I have very strong feelings about the HEI and the incredible importance and opportunity we have as health plans to help especially vulnerable populations. I look forward to seeing a lot of great innovation over the next year or so!

Keslie Crichton

Leading with help to improve how dual enrollment and SDoH services are delivered to your members!

2w

BeneLynk is ready to do our part to help you grow and maintain your Dual/LIS penetration. We can also assist and document your member's SRFs. But to Melissa’s point, whether it’s us, internal initiatives or another vendor, this takes time so the time to get started is now!

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