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From Medicare Advantage News - As the volume of encounter data collected by CMS grows — reaching an anticipated 775 million records for 2017 — the agency is working to ensure that data are accurate and complete through analysis, communications with Medicare Advantage organizations (MAOs) and other efforts that it will continue to refine, officials attested during a session of the CMS Medicare Advantage and Prescription Drug Plan Fall Conference, held Sept. 7 in Baltimore. CMS in 2012 began collecting data from MAOs through the encounter data system and in 2016 started phasing in EDS-based payments. Read more

From Health Plan Week - Dallas-based accountable care organization (ACO) Baylor Scott & White Quality Alliance (BSWQA) has been steadily adding health plans to its ranks. The ACO said Aug. 31 that it will be joining forces with Cigna Corp., the third health plan it has added since the ACO launched in 2013. Read more

From Health Plan Week - Congress has set the stage for a September return to debate on stabilizing the individual health insurance market, with major changes to Medicaid funding or expansion taking a back seat. Read more

From Medicare Advantage News - Net Promoter Scores (NPS) are generating plenty of buzz among Medicare Advantage plan sponsors, with executives boasting of increases as a proxy for customer satisfaction. But as sponsors approach the Oct. 1 start date of marketing for the 2018 plan year, experts urge plans not to rely exclusively on NPS, since it doesn’t provide the level of nuanced satisfaction information necessary to retain and especially gain members. Read more

From Specialty Pharmacy News - In 2015 and 2016, specialty net cost per claim had double-digit growth in the Medicaid fee-for-service (FFS) space, according to a new report from Magellan Rx Management. HIV/AIDS therapies led the specialty net spend for the second year in a row, with the average prescription net cost rising by almost 30% (see chart below). Six of the top 10 net spend drugs are in specialty classes: hepatitis C, hemophilia, HIV/AIDS… Read more

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