Now that the April 30 CMS deadline for submitting EDGE server data – and even the May 15th grace period – has passed, it’s a great time to step back and evaluate how your organization did.
We think a few key questions to ask are:
· How well did our approach to EDGE work?
· Did we have clean data to optimize our risk adjustment efforts?
· Were we able to respond to the constant change in CMS requirements in an effective manner?
· What improvements do we need to make?
The ACA has made an already complicated, competitive business even harder. And the fact is, many health plans — busy serving their members by providing quality care at a reasonable cost — simply don’t have the proper resources or experience in place to complete the arduous tasks needed to comply with the Premium Stabilization Programs. The EDGE server requirements are challenging — and they will continue to evolve. Even large health plans with corporate supports in place were hard-pressed to meet the 2014 requirements.
If you think there’s need for improvement, now’s the time to consider a new plan of attack for your 2015 submissions. Should you do it on your own? Before you decide, consider all the things that a proper EDGE server process should entail. Your solution should give you:
· On-time, accurate submissions
· Ongoing risk score optimization services
· Data management setup and continuous data management services
· At a minimum, quarterly analytic reporting
· A support staff to keep up with HHS changes and respond to their EDGE server inquiries
· Peace of mind and the ability to focus internal resources attending to your day-to-day responsibilities
If complying with CMS’s EDGE server requirements is taxing your organization’s resources, it’s time to consider partnering with a qualified EDGE server administrator, so you can get back to the business of offering quality health care. Contact us to learn more.
Bryan Briegel, Director of Operations
Anita Nair-Hartman, Vice President, Payer Strategy and Business Operations