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Is Dr. Smith in my network? MA enrollees want directories they can count on

by Danielle Moon, Specialist Leader, Deloitte Consulting LLP

During the early part of the decade, I was at the US Center for Medicare and Medicaid Services (CMS) where I headed a group that oversaw the Medicare Advantage (MA) program. At the time, MA provider directories really weren’t on our radar. But these electronic directories have come under scrutiny recently, and CMS is now conducting audits to help ensure the information is up to date and correct.

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Can MACRA promote greater synergy across Medicaid and Medicare APMs to transform care?

by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP

Recent legislative efforts to repeal and replace the Affordable Care Act (ACA) pushed Medicaid reform into the center of the health policy spotlight. However, while Congress was debating coverage expansion and federal financing, some states have been quietly implementing their own delivery reform in an effort to reward value-based care. Many Republican and Democratic governors alike have embraced alternative payment models (APMs) such as medical homes,

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Hotspotting helped show us the link between social determinants and health…so how do we fix it?

by Sarah Thomas, Managing Director, Deloitte Center for Health Solutions, Deloitte Services LP

It has been about six years since Atul Gawande, MD – a surgeon, writer, and public health researcher – profiled Jeffrey Brenner, MD, in an article in The New Yorker. Dr. Brenner used advanced analytics to identify patterns underlying health care utilization data, which he dubbed “hotspotting” It’s a term used by some police departments to identify high-crime areas.

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MACRA: Quietly transforming health care

by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP

It has been a couple weeks since House Republicans passed the American Health Care Act (AHCA). In my last My Take, I outlined the process the Senate will go through in moving the legislation forward, and what it will take to bring a bill to the president’s desk. While repealing and replacing the Affordable Care Act (ACA) is dominating the headlines and would certainly have a significant impact on the health care landscape,

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MACRA offers a bridge away from fee-for-service as good as the Golden Gate

by Bill Copeland, Vice Chairman, US Life Sciences & Health Care Industry Leader, Deloitte LLP

The idea of a bridge that could connect San Francisco to Marin County, California began to surface in the late 1880s as the region’s population started to boom.1 At the time, ferries provided an essential link between the two regions. In 1933 – decades after engineers began to discuss the concept of a bridge – construction began.

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