DST Healthcare Blog

To keep the conversation going with you as healthcare continues to evolve, we’re keen to bring you insights from our DST Health team. Whether it’s something about data and analytics, costs and quality, or the policies that continue to create change, we’re here to help you master the complexity and discover opportunity.

Where Is the Barrage of Policy Updates Taking Part D?

Erin Costell and Rayvelle Stallings, May 4, 2018

As a sponsor of a Medicare Part D plan, you may be feeling deluged with regulatory rules and policy changes coming in READ MORE...

Medicare Advantage: Changes Ahead for Risk Adjustment and Star Ratings

Mike Nemeth and Aaron Oliver, April 19, 2018

On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 Call Letter and simultaneously released the Final Rule. Medicare Advantage plans have a great deal of information to digest in these major policy updates. Among the many changes READ MORE...

Medicare Advantage 2019 Policies Increase Plans' Flexibility

Judith Nelson, April 19, 2018

CMS outlined several policy changes to improve drug utilization review controls to combat the Opioid misuse epidemic such as READ MORE...

Medicare Advantage Value-Based Insurance Design Model

Judith Nelson, January 10, 2018

On December 13, 2017, the Centers for Medicare and Medicaid Services (CMS) held an Open Door Forum to discuss the recently announced opportunity to apply for the calendar year (CY) 2019 Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model. This program first READ MORE...

Medicare Diabetes Prevention Program (MDPP)

Judith Nelson, December 5, 2017

The Centers for Medicare & Medicaid Services (CMS) announced that effective April 1, 2018, Medicare members with an indication of pre-diabetes are eligible for clinical interventions that consist of core and maintenance sessions to promote READ MORE...

Stars 2018: Work Smarter and Not Harder

Amy Salls, October 5, 2017

The Centers for Medicare & Medicaid Services’ (CMS) dramatic changes to the 2018 Star Rating cut points have proven that taking a "cruise control" approach to quality performance will no longer ensure you remain a 4 or 5 Star plan. Achieving and maintaining high READ MORE...

Payers and Providers as Allies

Adele Allison, July 27, 2017

Health plans have an opportunity to collaborate more fully with providers (physicians, nurse practitioners, physician assistants, pharmacists, and other clinicians) to achieve higher quality results in HEDIS® as well as other quality programs. There is a strong READ MORE...

Meeting the Challenges of RADV Expansion

Amy Salls, October 6, 2017

According to documents released earlier this year, the Government Accountability Office (GAO) discovered that the Centers for Medicare and Medicaid Services (CMS) had failed to recover up to $125 million in Medicare overpayments in 2007, alone. The GAO criticized READ MORE...

Podcast: Achieving Value in the Management of Chronic HCV Infection

AJ Ally, May 10, 2017

Achieving value in the management of chronic HCV infection is one of the most complex challenges facing health plans today. Listen as AJ Ally, R. Ph., MBA, Vice President of Clinical Programs at DST Pharmacy Solutions, talks about the READ MORE...

Fraud, Waste and Abuse: It's Complex and We Can Help

Judith Nelson, March 21, 2017

With the recent changes at the Federal level, one thing this is fairly certain is bipartisan commitment to combating Fraud, Waste, and Abuse. Fraud, Waste, and Abuse (FWA) costs the US healthcare system billions of dollars every year. In fact, the READ MORE...

Increasing Payer-Provider Collaboration With a Step-By-Step Approach to Data Sharing

Adele Allison, January 16, 2017

For health plans, payment reform brings new opportunities to collaborate more fully with providers. As payers and providers modernize reimbursement towards population-based payment, the data requirements and optimization needs become READ MORE...

Defining the Path Toward Value

Adele Allison, January 13, 2017

The path forward to align value-based payment models across public and private health plans has been laid out by the Health Care Payment Learning and Action Network (HCPLAN). The HCPLAN was formed by READ MORE...

A New Era of Payer-Provider Collaboration

Adele Allison, January 12, 2017

As the healthcare system moves away from fee-for-service payments toward value-based payment (VBP) and greater risk-bearing contracts, few providers are ready. A Deloitte 2016 survey reveals that half of physicians have not READ MORE...

Moving With Your Provider Network Through the Continuum of Value-Based Payment

Adele Allison, January 11, 2017

Health plans have worked to set up their provider networks strategically for many years. The goal has been to balance quality of care for their members with access to providers while also managing rising costs. READ MORE...





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