Insights

Providing Analytical Support to the Center for Medicare and Medicaid Services

August 31, 2017

LMI Staff

For the past 14 years, LMI has been helping the Centers for Medicare and Medicaid Services (CMS) enhance its stewardship of Medicare Advantage plans, which provide Medicare coverage to more than 10 million seniors.

We analyzed the benefits packages from more than 5,000 distinct plans to ensure that they satisfied CMS rules and regulations and did not discriminate against certain classes of beneficiaries. We also performed ad hoc evaluations for a range of topics: analyzing the degree of competition in markets served by health maintenance organizations; developing “fair market” commission limits for health insurance brokers and agents; and identifying health plans for possible elimination from the program because of their duplicative benefit designs or low enrollments—to name just a few.

Key to performing these analyses was AskMarty, a proprietary tool we developed to retrieve data quickly from more than 40,000 unique uploads of health plan data received during the last 4 years. Our ability to quickly access and use what amounts to 240 million data elements continues to prove a valuable resource for CMS leadership looking for in-depth analyses and answers to tough questions.

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