Resolutions for Providers Delivering Care to Medicare Advantage Patients in 2025
A new year doesn’t just signal a fresh start—it’s an opportunity. And if you’re delivering care to Medicare Advantage (MA) patients, 2025 holds the potential to be transformative. But let’s be honest: this landscape is complex, dynamic, and not for the faint of heart.
Medicare Advantage has never been just about meeting benchmarks or checking boxes. It’s about creating meaningful change—improving outcomes, refining processes, and redefining how care is delivered. With HCC v28 taking center stage, quality measures under a brighter spotlight, and Annual Wellness Visits (AWVs) offering unparalleled opportunities, this is your chance to lean in and lead.
So, let’s have a conversation about what’s next. How do you elevate your efforts, refine your strategies, and ensure that 2025 is a year of growth and achievement? Here are the resolutions that can take you there.
1. Master HCC v28: Coding as an Art Form
Let’s talk about the elephant in the room: HCC v28. This isn’t just another update—it’s a fundamental shift in how risk is evaluated and reimbursements are calculated. Think of it as moving from black-and-white sketches to full-color portraits. To succeed, you’ll need to train your team to paint the most accurate picture of each patient’s health.
What’s the move? Start with education. Make sure your team is fluent in the nuances of HCC v28, because precision coding is the linchpin of accurate risk adjustment. Lean on 837 data to identify diagnosis gaps in real time and ensure RAF scores reflect the complexity of care you’re delivering. And don’t forget to equip your organization with the right technology—tools that can analyze, predict, and guide you toward maximizing risk adjustment outcomes.
💡 AaNeel Helpful Tip: Host monthly “coding cafés” where your team can exchange insights, clarify guidelines, and tackle real-world scenarios. Empower them to approach coding as both a science and an art.
2. Unlock the Full Potential of AWVs: Your Secret Weapon
Let’s flip the script on AWVs. These visits aren’t just compliance exercises—they’re your secret weapon. AWVs give you a unique opportunity to dive deep into patient needs, uncover conditions that might otherwise go unnoticed, and lay the groundwork for long-term health.
Here’s how you maximize their potential: Start by striving for 100% participation. Every eligible patient should walk through your doors for an AWV—it’s that simple. During these visits, use the time wisely. Look for suspected HCC conditions, update care plans, and engage patients in proactive strategies that shift the focus from reactive treatment to prevention. The secret to AWV success lies in seamless workflows, so streamline processes to make them easy for both staff and patients.
💡 AaNeel Helpful Tip: Launch a creative, patient-friendly outreach campaign at the start of the year. Think beyond appointment reminders—offer educational content that explains the value of AWVs and why they matter for patients’ long-term health.
3. Quality as a Culture, Not a Metric
Let’s reframe how we think about quality measures. They’re not just a reflection of how well you’re doing; they’re a window into the care your patients are experiencing. In 2025, make quality a culture—not just a metric.
Start by closing care gaps. Screenings, follow-ups, lab work—proactive management here isn’t just about ticking boxes. It’s about ensuring your patients receive care that’s timely, targeted, and effective. Use dashboards tailored to Star Ratings to track your performance in real time, and don’t stop there. Make quality measures part of your team’s DNA. Celebrate improvements, no matter how small, and help your staff see the direct connection between their efforts and better patient outcomes.
💡 AaNeel Helpful Tip: Focus on quarterly goals for specific metrics, like improving diabetes management or boosting colorectal cancer screenings. Then, recognize and reward the teams driving those results.
4. Technology as Your Co-Pilot
Here’s the truth: you can’t navigate 2025 without technology as your co-pilot. It’s no longer just a tool—it’s your strategic partner.
AI-powered solutions can analyze patient data with precision, flagging risks and care opportunities you might otherwise miss. Real-time dashboards can keep your team informed and agile, helping you adapt as conditions change. But the key isn’t just adopting technology; it’s about choosing the right technology. Partner with vendors who understand the nuances of Medicare Advantage and can tailor tools to meet your specific needs.
💡 AaNeel Helpful Tip: Dedicate a quarterly “technology check-in” where you review the performance of your systems. Are they meeting your needs? Where can they be optimized? The right adjustments can unlock significant gains.
5. Patient Engagement: Beyond the Clinic Walls
Here’s a hard truth: patient outcomes aren’t determined solely by what happens in your clinic. They’re shaped by what happens when patients leave. Are they engaged? Do they understand their care plans? Are they adhering to their medications?
In 2025, make patient engagement a top priority. Start by ensuring every interaction is meaningful. Communicate regularly about care plans, preventative screenings, and adherence strategies. Use digital tools like portals or apps to send reminders, provide educational content, and share progress updates. And don’t underestimate the power of personalization—patients want to feel seen, heard, and valued.
💡 AaNeel Helpful Tip: Incorporate patient feedback surveys into your AWVs. It’s a simple, effective way to uncover blind spots and strengthen the provider-patient relationship.
6. Stay Curious: The Lifelong Learner’s Advantage
Healthcare evolves fast. Regulations change, technology advances, and new care models emerge almost overnight. Staying ahead means embracing a culture of lifelong learning—not just for yourself but for your entire team.
Attend webinars, workshops, and conferences focused on Medicare Advantage and value-based care. Partner with organizations that offer cutting-edge training in coding, quality improvement, and risk adjustment. And don’t just consume knowledge—share it. Build an internal culture where curiosity is celebrated, and learning is a shared pursuit.
💡 AaNeel Helpful Tip: Subscribe to a few high-quality Medicare Advantage newsletters or podcasts. They’re an easy, time-efficient way to stay updated on the latest trends.
7. Celebrate Progress: Big and Small
Success isn’t just about reaching your goals—it’s about recognizing the journey. Whether you hit participation targets for AWVs, close diagnosis gaps, or improve Star Ratings, take the time to celebrate progress.
Create a “Care Wall” in your clinic to showcase milestones and team achievements. Use meetings to highlight individual contributions and share patient success stories. Celebrate not just outcomes but the hard work and innovation that made them possible.
💡 AaNeel Helpful Tip: Tie celebrations to data. For instance, if your team improves diabetes control metrics by 10%, share how it impacts patient outcomes and recognize the effort behind the achievement.
The Road Ahead: Resolutions That Matter
The journey to success in Medicare Advantage is challenging—but the rewards, for your organization and your patients, are undeniable. By mastering HCC v28, maximizing AWVs, and fostering a culture of quality and engagement, you’ll set the foundation for a transformative 2025.
At AaNeel, we’re here to help you navigate the complexities of value-based care. From advanced analytics to tools that streamline workflows and improve outcomes, our solutions are designed to empower you. Together, let’s make 2025 a year of innovation, growth, and exceptional patient care.
🔗 Ready to take the next step? Discover how AaNeel can support your success in 2025.
