Aug 25 2022
Why You Shouldn't Settle for Partial Duals
Josh Weisbrod from Network Health and Keslie Crichton and Sean Libby from BeneLynk join Eric to discuss opportunities and challenges in identifying and converting members to full dual status, including specific examples and an outlined roadmap into this additional revenue stream. After listening to this episode, you will understand: Why identifying members as “full or partial” mattersHow much revenue you may be leaving on the tableWhat components need to be in place to convert members Our Guests Josh Weisbrod, Vice President, Risk Adjustment, Network Health Josh has over 20 years of healthcare, health insurance, healthcare analytics and human service experience working with local and national companies and state and federal agencies, specializing in health plan operations and data analytics. Sean Libby, President and Co-founder, Benelynk Sean has worked at the intersection of managed care and government benefit programs for the past 19 years. Before BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations. Keslie Crichton, Chief Revenue Officer, BeneLynk Keslie has over 25 years of comprehensive managed care and healthcare technology experience. Before BeneLynk She spent 13 years as Vice President of Sales at Change Healthcare and its predecessor companies Altegra Health and Social Service Coordinators, helping plans improve risk-adjusted revenue and quality performance scores through dual enrollment and retention, as well as health education campaigns. Acronym Glossary MSP - Medicare Savings ProgramsABD- Age Blind and DisabledMAPP - Medicaid Purchase PlanSSI - Supplemental Security IncomeQMB - Qualified Medicare BeneficiarySLMB - Specified Low-Income Medicare BeneficiaryQI-1 - Qualifying IndividualSNAP - Supplemental Nutrition Assistance ProgramLIS - Low-Income SubsidySSA - Social Security AdministrationCMS - Center for Medicare and Medicaid ServicesMAO - Medicaid Add OnMA - Medicare AdvantageHCC - Hierarchical Condition CategoryFPL - Federal Poverty LevelMAGI - Modified Adjusted Gross IncomePMPM - Per Member Per MonthHRA - Health Risk AssessmentD-SNPs - Dual Eligible Special Needs Plans We are pleased to provide you with this copy of the white Hi Sherry, Are you leaving revenue on the table? Find out by listening to our new episode, Why You Shouldn’t Settle for Partial Duals, now live on Apple, Google, Spotify, Amazon Music or your favorite podcast app, and YouTube. Josh Weisbrod, Vice President, Risk Adjustment, Network Health, Keslie Crichton, Chief Revenue Officer, BeneLynk and Sean Libby, President and Co-founder, BeneLynk, join me for an insightful discussion on the opportunities and challenges in identifying and converting members from partial dual to full dual status. Hear specific success stories and walk away with an outlined roadmap for capitalizing on this additional revenue stream. In addition, we are pleased to provide this whitepaper, Are You Getting Partial Dual Premiums for Partial Dual & Full Dual Risk?, from our partner BeneLynk. I hope you find it valuable. BeneLynk sponsors this Episode of Bright Spots in Healthcare. BeneLynk is arguably the most innovative Dual Advocacy organization in the country. Benelynk’s mission is to improve people’s lives and positively impact social determinants of health barriers by granting their healthcare partners the necessary information while providing healthcare consumers with the advocacy they deserve. They use innovative technology that enables their people to have a dynamic conversation that flows organically to meet social determinants of health challenges and, as such, can build stronger human connections. This carefully planned combination generates exceptional results. Visit their website at www.benelynk.com