Building an Operational Model for Whole-Person Care

Members’ needs rarely fit neatly into a single program. Medical, behavioral, and social factors frequently intersect, requiring coordination across care management, utilization management, behavioral health, primary care, specialists, and community-based organizations. Most healthcare organizations recognize this reality. The challenge isn’t identifying members’ needs. It’s creating an operational model that enables teams to consistently coordinate care… Continue reading Building an Operational Model for Whole-Person Care

Building a Modern Technology Framework for I/DD Programs and Providers

Managing services for individuals with intellectual and developmental disabilities (I/DD) has never been more complex or more essential. As states and managed care organizations modernize their I/DD systems, the focus is shifting from administrative oversight to integrated, person-centered care powered by data and technology. But this next chapter isn’t only about efficiency. It’s about dignity,… Continue reading Building a Modern Technology Framework for I/DD Programs and Providers

The New Road to Five Stars: Integrated Care Management for 2026 Star Ratings and Beyond

Health worker puts the rating stars on blurred background.

Medicare Advantage (MA) plans continue to face mounting pressure to achieve high Star Ratings, comply with evolving CMS regulations, and deliver equitable, high-quality care. The 2025 Star Ratings averaged just 3.74 (weighted by enrollment), leaving many plans short of their quality and revenue goals. With ~$16 billion in quality bonuses on the line, performance in… Continue reading The New Road to Five Stars: Integrated Care Management for 2026 Star Ratings and Beyond