The Compliance Advantage in Medicare Advantage: A Journey From the Brink to the Forefront

QualChoice Health will share the journey of its largest Medicare Advantage plan, SoundPath Health, in deploying Pega’s CRM and workflow capabilities to realize dramatic improvements in its CMS Appeals compliance and Medicare STAR Ratings. Learn how increasing CMS audit pressure combined with financial incentives continues to push the industry to rapidly evolve in this high risk area. The presentation will cover key aspects of SoundPath’s ega deployment and how organizations can deploy their own strategies to stay ahead of the CMS audit risk while driving member, provider, and employee satisfaction.


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