
Digital Modernization
Training and Technical Assistance for Part C & D Plans
Since 2019, APV has partnered with the Centers for Medicare & Medicaid Services (CMS) Medicare Plan Payment Group (MPPG) to support critical Medicare Advantage Organizations (MAOs) (Part C) and Prescription Drug Plans (PDPs) (Part D) programs. MPPG oversees risk adjustment operations, payment reconciliation, encounter data processing, and policy implementation to help ensure accurate payments and effective program administration for millions of Medicare beneficiaries.
To support this mission, APV provides a combination of technical, operational, training, outreach, and project management services across multiple CMS divisions. The team delivers subject-matter expertise in risk adjustment, encounter data, payment operations, and Medicare policy while supporting CMS systems, stakeholders, and program participants nationwide.
As CMS program requirements evolved, APV helped strengthen communication, education, and operational support for MAOs and PDPs. The team developed and maintained user guides, computer-based training courses, webinar content, and educational materials that translated complex policy and system changes into practical guidance for stakeholders. APV also supported the Inquiry Management System (IMS), providing technical assistance and policy support to plans, analyzing inquiry trends, and helping CMS identify opportunities to improve stakeholder education and operational efficiencies.
In addition, APV supported project management activities throughout the CMS Target Lifecycle, including release management, governance compliance, stakeholder coordination, reporting, and process improvement initiatives. Through structured oversight, standardized procedures, and continuous collaboration with CMS subject matter experts, APV helped streamline workflows, improve responsiveness, and enhance the quality of services delivered to Medicare program participants.
Benefits/Outcomes
- Since 2021, resolved inquiries received through the Inquiry Management System (IMS) have helped reduce CMS workload by more than 77%, while improving response timeliness and consistency.
Developed innovative computer-based training courses, educational materials, and user guides that improved stakeholder understanding of risk adjustment methodologies, encounter data submission requirements, payment reconciliation processes, and CMS systems.
Supported annual updates to Risk Adjustment Methodology training, enabling health plans to better understand policy changes, risk score calculations, and operational impacts.
Produced weekly reports, dashboards, and trend analyses that helped CMS identify frequently asked questions, improve stakeholder communications, and target future training opportunities.
Facilitated large-scale webinars with more than 1,000 registrants, increasing stakeholder engagement and awareness of CMS policy and operational updates.
Implemented standardized project management practices, SOPs, and delivery tracking processes that improved coordination across multiple CMS divisions and reduced project completion timelines.
Ensured adherence to Section 508 accessibility requirements for training and outreach products.
Tools and Technologies
Salesforce, SharePoint
APV Corporate
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