Healthcare team discusses Medicare Advantage program optimization in meeting.

Medicare Advantage Program Optimization

Helping architect the framework and optimize the performance of your organization’s Medicare Advantage program.

Medicare Advantage (MA), also known as Medicare Part C, accounts for more than a third of all Medicare recipients. With membership continuing to rise, it is imperative for health plans running an MA plan to define their network strategy, have insights into member experience and provider ratings, and understand population health trends if their program is to remain, or become, profitable.

    Baker Tilly understands your MA program’s most pressing problems and recognizes that each stakeholder, both inside and outside of your organization, has different needs. In order to form a cohesive strategy across all groups, Baker Tilly’s team of Value Architects™ is able to offer an integrated set of solutions that helps build and optimize your MA program’s objectives and related operational capabilities.

    Success in the MA space is dependent on an integrated organizational approach that focuses on provider network design and contract strategy, value-based incentive models aligned to patient health outcome and MA program goals (e.g., STARs and Risk Adjustment), risk adjustment program management, a focus on data management and project and program delivery skills that brings all of the pieces together.

    Case study

    Baker Tilly assists post-acute care organization in assessing risk readiness to prepare for value-based reimbursement

    A post-acute care organization with a multistate presence signed contracts with managed-care organizations and was approached by several hospitals to participate in risk-based episodes of care for patients requiring short-term inpatient rehabilitation.

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    Case study

    Large multistate health plan implements healthcare analytics platform expanding quality management and risk reporting capabilities