LMI’s compliance approach centers on reducing programmatic risks while minimizing participants’ burden through data analytics and proactive engagement and education.
Reducing Program Risk and Stakeholder Burden
LMI has supported federal healthcare initiatives for over 20 years, furnishing analytic tools, policy expertise, and operational knowledge to enhance program oversight and model compliance activities. Through prospective and retrospective analysis, LMI helps the Centers for Medicare & Medicaid Services (CMS) and other federal customers monitor and manage significant programs, uncover risks, and determine mitigation strategies that lessen the burden for stakeholders. These strategies support the implementation of models of care that deliver quality, cost-effective health outcomes and ultimately foster a more efficient healthcare system.
LMI has supported CMS offices and programs for over 20 years, furnishing project and program management, compliance planning and oversight, and stakeholder engagement and education.
LMI has supported compliance oversight for six CMMI models:
- Comprehensive Primary Care Plus (CPC+),
- Comprehensive End-Stage Renal Disease Care (CEC),
- Accountable Care Organization Investment Model (AIM),
- Pioneer ACO,
- Next Generation ACO, and
- Advance Payment.
Among its program integrity responsibilities, LMI audits the CPC+ model, which consists of nearly 3,000 primary care practices in 18 regions, and performs scheduled and ad hoc auditing for CEC and Next Generation ACO model participants.
LMI analyzed and monitored compliance of over 5,000 care plans for the MA program, which covers more than 20 million beneficiaries. LMI built an integrated suite of in-house systems and customized tools to perform qualitative and quantitative analyses of each plan. LMI’s approach has accelerated processing of repetitive requests, enabling customers to spend more time and resources on time-sensitive and emerging benefit policy issues. With over two decades of experience in supporting MA across seven divisions, LMI’s analyses inform updates on the health of the program to external stakeholders and afford insight into program improvements.
LMI’s health policy experts have drafted and cleared sections of proposed and final rules, prepared reports to Congress, and presented detailed accounts of model performance and program findings to external stakeholders on behalf of several CMS customers, including CMMI, the Center for Consumer Information and Insurance Oversight, Medicare Advantage, and the Medicare Shared Savings Program.
Stephanie FrillingSr. Consultant, Policy
Stephanie brings over 20 years of experience in public health, care delivery, private insurance, and quality improvement methods to LMI’s federal healthcare customers. She has extensive regulatory and policy understanding of alternative payment models and payment incentives that drive quality and improve patient outcomes.