2025 Outlook: A Year of Innovation, Equity, and Transformation in Healthcare

As we enter 2025, the healthcare industry stands at a pivotal moment shaped by transformative trends from the past year. Advancements in artificial intelligence (AI), escalating healthcare costs, and heightened cybersecurity threats have underscored the need for innovation, resilience, and adaptability. These challenges have also opened the door to meaningful opportunities—to optimize healthcare delivery, improve […]
Unlocking Revenue and Quality Care: How Accurate Risk Adjustment Drives Success in Medicare Advantage

Since the 1980s, Medicare-eligible individuals have had the choice between the traditional fee-for-service plan, where the federal government pays healthcare providers a set fee for each service, and Medicare Advantage (MA), where the government pays private health plans a fixed amount for each enrollee. Today, over half of all Medicare beneficiaries are enrolled in Medicare […]
Stuck in 3-Star Purgatory? How Annual Programming Can Propel Your Health Plan to 4 and 5 Stars

For many health plans, breaking free from a 3-Star rating can feel like an insurmountable challenge. Being stuck in this ratings purgatory not only limits your access to quality bonus payments but also hampers your ability to attract new members and diminish your overall plan reputation. Achieving higher ratings is not just a matter of […]
That’s a Wrap on RISE National 2024!

Last week, thousands of health plans, healthcare providers and healthcare technology executives descended on Nashville to drive spirited conversation around best practices for elevating member satisfaction, matching appropriate risk adjustments with care adherence and improving Star Ratings for Medicare Advantage plans. Over the course of the three-day RISE National Conference, the ReferWell team welcomed the […]
Transforming Member Experience: A Success Story from Select Health

In the dynamic landscape of healthcare, providing an exceptional member experience is paramount. However, achieving this goal can be challenging, especially for large health organizations grappling with complex systems and processes. In a recent podcast episode, we had the privilege of exploring how Select Health, a leading health plan, successfully tackled their member experience issues. Let’s […]
Harnessing Member Data to Schedule and Close Care Gaps

Health Plans can revamp their member outreach and appointment scheduling process to close care gaps faster by using insights gained from member data. Healthcare has invested heavily in data solutions to identify members with open care gaps. Still, plans often struggle to get these members to schedule care gap appointments (for a few reasons). And, […]
A Proven Strategy to Boost Referral Volume and Skyrocket Your Appointment Bookings

ReferWell’s Client Operations Team is often approached by specialty practices, outpatient surgery centers, hospitals, and health systems seeking better ways to increase referral volume. While they have tried digital marketing, they are aware of anti-kickback laws. In that vein, ReferWell has collaborated with Lenox Hill Radiology (LHR), which operates over 70 imaging centers in the […]