Penstock

Good news for issuers: CMS’s consistency with the AV calculator means simpler planning from 2025 into 2026. In the latest episode of #RegulatoryJoe,?Joe Boyle?highlights how CMS maintaining consistency across metallic tiers is giving health plans?predictable parameters for upcoming plan years. #HealthPlans #CMS #AVCalculator

Your internal team is so much more than a recovery center. Penstock will arm you with the tools to self-serve by making payment accuracy a core in-house competency. From building robust audit workflows to transparent training, tech and education, we help you find more recoveries while fostering a smoother, happier experience for all parties—including your members and providers. Get started:?https://lnkd.in/epPR9YmQ #PaymentIntegrity #Auditing #PaymentAccuracy

The energy last week at #MAHP2024 was unmatched!?Penstock?was proud to be there, represented by?Joe Boyle, Paul Notarnicola and Hadley Waterbury. Our favorite highlights included: ?? MA HHS Secretary?Kate Walsh?diving into the potential impacts of the 2024 election results on the Affordable Care Act ?? Insightful conversations with regulators, payers and industry leaders about mitigating risks and ensuring affordability for the 370k+ lives insured through the Massachusetts Health Connector ?? NBC's?Chuck Todd?providing an in-depth analysis healthcare trends and policies, including key factors influencing quality and access to care The biggest takeaway? Supporting affordable healthcare is more important than ever. As potential new policies and changes to the ACA are considered, we're committed to helping our partners stay ahead of these shifts and ensure members can access the care they deserve. Thank you to the Massachusetts Association of Health Plans?for a fantastic conference—we’re already looking forward to next year!

Pro tip: avoid last-minute AV calculator surprises by staying ahead of CMS's release timeline. In the latest episode of Regulatory Joe,?Joe Boyle dives into how tracking the NBPP release helps health plans anticipate CMS’s draft AV tools—giving your team the time they need to prepare, test, and finalize plans smoothly. ?? Check out the full episode to learn more:?https://lnkd.in/eUrNvKeR #RegulatoryJoe #HealthPlans #ACA

Compliance doesn't have to be complicated. Whether you're a PBM trying to secure your Certificate of Authority (COA) license or a TPA looking to manage your Life and Health Administrator Licenses, we take care of it all—so you can stay focused on your core business. ?? Curious to learn more? Swipe through to explore our innovative approach and see why Penstock is the go-to for your regulatory needs. #RegulatoryCompliance #TPA #PBM

Entering or expanding into new #ACA markets is no easy task—but with the right strategies, your plan can navigate complexities with a competitive edge. Join?New York Health Plan Association on Wednesday, December 4 at 2pm ET for a webinar designed to help set your health plan apart and drive success in this competitive space, featuring powerful insights from?Softheon's Kevin Deutsch?and Penstock's own?Joe Boyle. ???Register now?to secure your spot:?https://lnkd.in/es5KG8G7

Will we see you in New York next week for the New York Health Plan Association's Annual Conference? With conversations on AI's role in the marketplace and the impact of DEI initiatives in healthcare, this two-day event is sure to be filled with meaningful connections and actionable insights into the future of health plans across the state. Reach out to Paul Notarnicola and Jeffrey Snyder, AHFI to set up a time to connect and learn how Penstock is powering a new generation of forward-thinking health plans with everything from regulatory filing and payment integrity to HCRA compliance.

Audits that work. Results that matter. When a Medicare Advantage Plan needed to review thousands of claims for accuracy, Penstock stepped in with advanced algorithms, innovative ClearBridge technology, provider outreach and more to conduct over 12,000 post-payment audits. The result? $13.1 million in savings and a 54.4% overall savings rate. Learn more about how Penstock is delivering real results for health plans: https://hubs.li/Q02XPSXS0 #MedicareAdvantage #HealthPlan #PaymentAccuracy

Mastering the actuarial value (AV) calculator is your secret weapon for compliance and regulatory success. In the newest episode of Regulatory Joe, Joe Boyle is breaking down everything health plans need to know for 2025, including: ??How this year’s AV consistency supports streamlined planning ??Why you should test your plans early with the draft calculator ??Version control best practices to avoid compliance issues ??And more! PS. All Regulatory Joe episodes are now streaming wherever you listen to podcasts! ?? #RegulatoryJoe #HealthPlans #AVCalculator

What would permanent ACA subsidies mean for health plans? More stability, more competition and a bigger insured population. But if these subsidies end, plans could face rising premiums, membership losses and much more. Our latest article explores the Healthcare Affordability Act and how health plans can proactively plan for the future. Now is the time for plans to evaluate resources, reassess plan portfolios and prepare for possible subsidy changes. Read on for our experts' insights down below! #HealthPlans #ACA #HealthcareAffordabilityAct #ARP