Solutions: Lines of Business

/ Solutions / Lines of Business /

Delivering Innovative Solutions to Government Health Plans

Stay ahead of changing rules and regulations with Advantasure experts and adaptable solutions for Medicare Advantage, Commercial ACA and Dual Eligible Special Needs Plans.

Increased Functionality, Better Numbers

  • Continuously improve products, processes and programs
  • Improve administrative loss ratios
  • Boost Star ratings
  • Expand market share or enter the market

Reduce Complexity. Accelerate Performance.

Sustainable government healthcare programs need effective administrative cost management, quality patient outcomes and experiences, enrollment growth, regulatory compliance, and the flexibility to constantly adapt business processes and programs. That’s a tall order!

Our experienced compliance team can help you navigate through the complexity. Our professionals from across the industry are experienced with health plans, providers, regulatory agencies and other organizations. We monitor and communicate with CMS to ensure solutions are complete, up-to-date and compliant.

Medicare Advantage: Some 3.5 million Americans become eligible for Medicare every year.

Medicare Advantage is a specialty … and we know what it takes to successfully manage and operate an MA plan.

Whether your plan is large and established or a new entry into the MA market, Advantasure has experience accelerating business success and helping deliver better member experiences and improved health outcomes.

Our scalable solutions automate all key processes in the Medicare cycle, including core administration, risk adjustment and quality.

Commercial ACA: Optimizing Performance

The opportunities and challenges of the Commercial Affordable Care Act (ACA) marketplace drive the need for business efficiencies and accelerated improvements.

Backed by experienced teams who understand all the nuances, trends and demands of the ACA, Advantasure delivers critical insights and analysis to improve risk score accuracy and boost business results. We offer prospective and retrospective gap identification, provider engagement, and other risk adjustment solutions to meet your needs.

DSNP: Experience Drives Results

Dual Eligible Special Needs Plans demand a unique approach to providing care. At Advantasure, we combine our deep knowledge of government programs with a suite of innovative services for the best combination of integrated administrative, risk adjustment and quality solutions.

Together, we’ll help accelerate your business success and help you more effectively manage this special member population.

End-to-End Solutions with Exceptional Delivery

You can select from a comprehensive suite of products and services that meet specific and defined needs or select a fully integrated solution that manages all your plan functions. In both cases, you’ll be supported by a team of experienced industry professionals dedicated to helping simplify your complex healthcare operations.

Learn More: Product and Service Solutions

Find Out How We Can Help You Drive Forward

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