@RISEhlth

Join the movement to drive positive change in health care

 BiCoastal
risehealth.org
Joined May 2010
  • Tweets11.1K
  • Following3.2K
  • Followers2K
4.5KMedia
Meet the speakers for our brand-new Medicare Product and Pharmacy Strategy Summit, taking place June 11-12 in Seattle. View Speakers: buff.ly/2p9o3j8 #MPPS2026 #Medicare #MedicareAdvantage #MedicarePartD
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Turning CMS rule changes into quality performance gains via @Labcorp risehealth.org/insights-arti…

Turning CMS rule changes into quality performance gains

What 2026 and 2027 updates mean for quality performance and revenue.

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CMS imposes six-month nationwide freeze on Medicare hospice, home health agency enrollments risehealth.org/insights-arti…

CMS imposes six-month nationwide freeze on Medicare hospice, home health agency enrollments

The agency said the move is part of the administration’s crackdown on fraud, waste, and abuse in the Medicare program.

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#RISERadio Episode 32: Flex cards and SSBCI changes under the 2027 Medicare Advantage Final Rule risehealth.org/insights-arti…
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Report: 4M Latinos may lose health care coverage due to Medicaid, ACA cuts buff.ly/r4cdQJn

Report: 4M Latinos may lose health care coverage due to Medicaid, ACA cuts

A new report from UnidosUS, a Latino civil rights and advocacy group, warns that the federal policy changes are poised to reverse 14 years of progress in Latino health coverage and urges Congress to...

risehealth.org
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Member education that sticks: How Medicare Advantage plans can drive better engagement via @Official_TTHM risehealth.org/insights-arti…

Member education that sticks: How Medicare Advantage plans can drive better engagement

Medicare Advantage organizations put a lot of time and effort into member communications, but even well-intentioned messages can get overlooked. The issue is not always the information itself. More...

risehealth.org
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Ax the fax: Clearing the paper jam in claims operations via @centaurihs buff.ly/L6t6V9p

Ax the fax: Clearing the paper jam in claims operations

The Claims Attachments Final Rule (CMS‑0053‑F) is a turning point for both commercial and government health plans because it finally standardizes under HIPAA the electronic exchange of the supporting...

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#Webinar From Audit to Advantage: Turning RADV Readiness into a Prospective Risk Strategy May 19 In partnership with @Navina_ai Register: buff.ly/sfd5Itw #Medicare #MedicareAdvantage #ACA #riskadjustment #valuebasedcare
From Audit to Advantage: Turning RADV Readiness into a Prospective Risk Strategy | May 19 | In partnership with Navina

ALT From Audit to Advantage: Turning RADV Readiness into a Prospective Risk Strategy | May 19 | In partnership with Navina

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RISE launches new summit uniting Medicare Advantage product and Part D strategy, June 11-12 in Seattle. buff.ly/ODRxiC0
The RISE Medicare Product and Pharmacy Strategy Summit | June 11-12, 2026 in Seattle

ALT The RISE Medicare Product and Pharmacy Strategy Summit | June 11-12, 2026 in Seattle

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Regulatory Roundup: CMS Part D demo to offer GLP-1s for $50 per month; House oversight committee flags CPT coding as improper payment driver; and more risehealth.org/insights-arti…

Regulatory roundup: CMS Part D demo to offer GLP-1s for $50 per month; House oversight committee...

RISE summarizes recent regulatory-related headlines and reports.

risehealth.org
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We close gaps in diabetes care, hypertension care, and cancer screening. Why not cognition? via @trycreyos risehealth.org/insights-arti…

We close gaps in diabetes care, hypertension care, and cancer screening. Why not cognition?

Health plans and risk-bearing providers have become remarkably good at finding care gaps. An overdue A1c. A missed blood pressure follow-up. A patient who has not completed colorectal cancer screen...

risehealth.org
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Study: #MedicareAdvantage plans that break the rules often receive modest cash fines risehealth.org/insights-arti…

Study: Medicare Advantage plans that break the rules often receive modest cash fines

Federal oversight of Medicare Advantage is entering a more scrutinized era, but new research suggests the enforcement tools used most often may be too small to meaningfully deter repeat offenders.

risehealth.org
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NEW #WebinarFrom Reactive to Proactive: How Claremedica Rebuilt Its Approach to Dementia Detection in a Full-Risk Model June 4 In partnership with @trycreyos Register:risehealth.org/events/from-r…
From Reactive to Proactive: How Claremedica Rebuilt Its Approach to Dementia Detection in a Full-Risk Model | June 4 | In partnership with Creyos

ALT From Reactive to Proactive: How Claremedica Rebuilt Its Approach to Dementia Detection in a Full-Risk Model | June 4 | In partnership with Creyos

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RISE retweeted
STAT
@statnewsMay 6
Policy recommendations in OpenAI's blueprint for unlocking AI’s potential to change health care are reasonable, but also self-serving, experts say. trib.al/ZsACAr6

OpenAI wants to ‘have their cake and eat it too’ with health AI policy recommendations

Policy recommendations in OpenAI's blueprint for unlocking AI’s potential to change health care are reasonable, but also self-serving, experts say.

statnews.com
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.@AlignmentHealth CEO expects short delay for CMS' proposed risk adjustment changes bit.ly/3QI9vaj

Alignment CEO expects short delay for CMS' proposed risk adjustment changes

Alignment Healthcare executives weighed in on the final Medicare Advantage rate notice last week, with CEO John Kao saying he expects regulators to return to plans for a new risk adjustment model i |...

fiercehealthcare.com
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Starting in July, people on Medicare might be able to get weight loss drugs, such as Wegovy and Zepbound, for $50 a month. It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments. @JackieFortier reports ⤵️ kffhealthnews.org/medicare/c…

A New Medicare Option for Weight Loss Drugs: What Older Americans Should Know - KFF Health News

It may soon get easier for millions of people with Medicare to get discounted GLP-1 drugs for weight loss.

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States eye aid to prop up distressed hospitals amid federal Medicaid cuts bit.ly/4tjCXAZ

States eye aid to prop up distressed hospitals amid federal Medicaid cuts

LOS ANGELES—At Martin Luther King, Jr. | Across the U.S., hospitals and patient advocates are looking to state lawmakers and local officials to help shore up shaky finances.

fiercehealthcare.com
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UnitedHealthcare to cut prior authorization requirements for 30% of services risehealth.org/insights-arti…

UnitedHealthcare to cut prior authorization requirements for 30% of services

By the end of 2026, UnitedHealthcare plans to eliminate an additional 30 percent of health care services that previously required the insurer’s approval.

risehealth.org
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The workshops at #Qualipalooza2026 are unmatched, bringing you the latest regulatory changes and trends to help you build a quality strategy for success. View the Full Agenda: buff.ly/ot49dvB #Starratings #Medicare #MedicareAdvantage
Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop A: Quality Data Evolution: Best Practices in a Time of Change

ALT Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop A: Quality Data Evolution: Best Practices in a Time of Change

Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop B: Navigating the New Reality of Medicare Advantage: What CMS’s Latest Final Rule Means for Your Path Forward to Star Ratings Success

ALT Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop B: Navigating the New Reality of Medicare Advantage: What CMS’s Latest Final Rule Means for Your Path Forward to Star Ratings Success

Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop C: Medicare Advantage 101-201 (Understanding the Fundamentals and Why Star Ratings Drive Everything)

ALT Qualipalooza | June 28-30, 2026 | Dallas | qualipalooza.risehealth.org Workshop C: Medicare Advantage 101-201 (Understanding the Fundamentals and Why Star Ratings Drive Everything)

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From retrospective to prospective: What the final CMS ruling confirms about the future of risk adjustment via @Veradigm risehealth.org/insights-arti… #Medicare #MedicareAdvantage #riskadjustment

From retrospective to prospective: What the final CMS ruling confirms about the future of risk...

With CMS' Advance Notice and the CY 2027 MA and Part D Final Rate Announcement now finalized, regulatory direction is clear. CMS has provided consistent signals through both early policy guidance and...

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