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Long-Term Care: The Problem - Paragon Institute
WebEvaluate how effective the solution was. Decide whether the existing plan needs to be revised, or whether a new plan is needed to better address the problem. If you are not pleased with the outcome, return to step 2 to select a new solution or revise the existing solution, and repeat the remaining steps. Problem solving is something we do every ... WebFeb 3, 2024 · 2. Ensuring Proper Capitated Payment Rates. Per member per month rates paid to Medicaid MCOs must be “actuarially sound.” Meaning, these rates must be … WebSep 8, 2024 · The continued focus of CMS on eliminating Medicaid and Medicare fraud, waste and abuse means that health plans need to properly utilize technology to gain transparency into their process. Health plans and managed care organizations have to connect large volumes of data in order to comply with fraud, waste and abuse regulations. greenport wine and spirits