Beyond Quality S1 E1: Quality Is A Financial Strategy скачать в хорошем качестве

Beyond Quality S1 E1: Quality Is A Financial Strategy

What if your quality program was actually the most important financial lever your health plan has, and almost no one in the building knew it? In the premiere episode of Beyond Quality, host Rex Wallace and episode's 1 co-host Nate Lucena sit down with Eve Anderson, Director of Actuarial Services at Zing Health, and one of the few professionals who speaks both the language of quality strategy and actuarial finance. Eve brings a decade of Medicare Advantage experience, including bid strategy, risk adjustment, and value-based care, to a conversation that most health plans desperately need to have. She walks us through the financial trap that smaller and growing MA plans fall into, explains why ROI in quality improvement is so hard to measure (and what to do about it anyway), and makes the case that quality isn't just a program you run, it's a financial strategy you live by. This episode gets into the mechanics most quality leaders rarely see: how CMS rebates and Quality Bonus Payments flow through a bid, why smaller plans end up operating at a loss trying to compete with five-star giants, how the Inflation Reduction Act's Part D redesign forced a real showdown between finance teams and quality teams, and why the organizations that figure this out first have a serious long-term edge. If you've ever struggled to secure leadership or finance to invest in quality improvement, this conversation provides the framework and language to make that case. #MedicareAdvantage #StarRatings #CAHPS #HealthcareQuality #QualityImprovement #PatientExperience #HealthPlanStrategy #QualityBonusPayment #MedicareStars #ValueBasedCare #HealthcareFinance #BeyondQuality