Gartner Research

Top Pain Points and Solutions for U.S. Healthcare Payer CIOs in Government Programs

Published: 20 October 2017

ID: G00340195

Analyst(s): Bryan Cole

Summary

U.S. healthcare payer CIOs who support Medicare Advantage, managed Medicaid and ACA exchange individual segments must respond to changing regulations, while optimizing revenue and keeping operations humming. Use these common peer questions and Gartner insights to succeed in tough markets.

Table Of Contents

Analysis

  • How Do You Know Which Risk Adjustment Optimization Vendor Performs the Best?
  • Are There Vendors Aiding Medicare Advantage, ACA Exchange Individual and Managed Medicaid Enrollment and Reconciliation?
  • Are There Solutions That Will Speed Up HEDIS Reporting and Help Improve Our Medicare Advantage Star Ratings?
  • How Will ACA Repeal Discussions Affect My ACA Exchange Individual and Managed Medicaid Lines of Business?
  • How Do Other Government Programs Payers Manage Compliance Across the Enterprise?

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