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CMS' rewards programs can impact MAO's bottom lines

Novu Health

CMS’ rewards programs can impact MAO’s bottom lines by NovuHealth

Below is an excerpt from CEO Tom Wicka's latest feature in Managed Healthcare Executive:


Last month, the Centers for Medicare and Medicaid Services (CMS) finalized its guidance on Rewards and Incentive Programs (RI Programs). These guidelines are applicable today and enable Medicare Advantage Organizations (MAOs) to offer health-driven incentive programs that may be applied to an expanded list of health-related services and activities. However, some restrictions in the structure and framework of these programs must be taken into account to succeed.


Innovative MAOs are developing or implementing programs that provide rewards and incentives to enrollees for participating in activities that improve health, prevent injury and illness, and promote efficient use of healthcare resources. Many of these preventive and efficiency areas also align with an MAO’s quality measures and outcome performance, and therefore impact P&L.


But make no mistake — this is not an easy task, nor is it a game for amateurs. There are many voices in this discussion, but to be effective here requires both regulated industry and loyalty marketing expertise. Not optimizing your rewards strategy in the right way will either result in a blown budget or fines from CMS.


You can read Tom's full article at the Managed Healthcare Exec site here.

Read more about Novu's dynamic rewards solution here.