Our latest healthcare insights and perspectives
QUALITY AND STARS
White paper: Implementing a digital quality strategyKatie Devlin, DHSc, MS, CPHIMS
Sep 20, 2023
QUALITY AND STARS
NCQA confirms HEDIS® updates for Measurement Year (MY) 2024Samantha Davis
Sep 18, 2023
PAYMENT INTEGRITY
Savings spotlight: Dental claim review expertise nets significant savingsSteve Canfield, DDS
Sep 13, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Finding new schemes with AI and investigative techniquesErin Rutzler
Sep 11, 2023
QUALITY AND STARS
Podcast: Enhancing interoperability for better risk and quality outcomesKassi Yozzo
Sep 6, 2023
QUALITY AND STARS
Closing the Gap: Maintaining healthy cholesterol and improving medication adherenceMatt Simon
Aug 31, 2023
PAYMENT INTEGRITY
Podcast: Payment integrity for self-insured (ASO) employer groupsJeff Robinson
Aug 16, 2023
PAYMENT INTEGRITY
Video: A new approach to prepay coordination of benefits (COB) validationNaomi Murphy
Aug 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutidesMelanie Poole
Aug 2, 2023
QUALITY AND STARS
Closing the Gap: National Immunization Awareness MonthJamison Gillitzer
Jul 31, 2023
QUALITY AND STARS
Navigating changes in Star Ratings programs: Enhancing success with four key stepsMarge Ciancetta
Jul 24, 2023
PAYMENT INTEGRITY
Webinar: Making payment integrity work for your self-insured groupsAllyn Sullivan
Jul 19, 2023
PAYMENT INTEGRITY
4 strategies to curb medical cost increases as healthcare utilization reboundsMatthew Hawley
Jul 10, 2023
QUALITY AND STARS
Closing the Gap: Minority Mental Health AwarenessKatie Devlin, DHSc, MS, CPHIMS
Jun 29, 2023
CONSUMER ENGAGEMENT
Podcast: Preventing coverage loss during redeterminationJeff Robinson
Jun 14, 2023
QUALITY AND STARS
Preparing for a “Universal Foundation” of quality measuresBranka Sustic
Jun 12, 2023
FRAUD, WASTE, AND ABUSE
How to sequence FWA investigations for greater impactErin Rutzler
Jun 7, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging high-frequency telehealth claimsErin Rutzler
Jun 1, 2023
QUALITY AND STARS
Webinar: Optimizing MA Star Ratings with Star IntelligenceAshley McNairy
May 23, 2023
PAYMENT INTEGRITY
White paper: The “smart prepay” approach to payment integrityMatthew Hawley
Apr 20, 2023
QUALITY AND STARS
CONSUMER ENGAGEMENT
Closing the Gap: National Minority Health MonthLeah Dewey
Apr 17, 2023
PAYMENT INTEGRITY
Savings spotlight: Cotiviti takes on payment integrity in 5 new case studiesWarren Lesnefsky
Apr 3, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Prepay review leads to >$100K in projected annual savingsErin Rutzler
Mar 28, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Sequencing investigative activities for greater provider impactErin Rutzler
Mar 22, 2023
QUALITY AND STARS
Closing the Gap: Improve screening rates during Colorectal Cancer Awareness MonthThelma Belli
Mar 21, 2023
FRAUD, WASTE, AND ABUSE
Podcast: How health plans investigate and prevent FWAJeff Robinson
Mar 2, 2023
QUALITY AND STARS
Summary: NCQA releases proposed HEDIS changes for MY 2024 and MY 2025Samantha Davis
Feb 23, 2023
QUALITY AND STARS
Closing the Gap: Preventative measures for better heart healthAshley McNairy
Feb 21, 2023
QUALITY AND STARS
Rounding up Star Ratings changes in the 2024 Advance NoticeAshley McNairy
Feb 16, 2023
RISK ADJUSTMENT
Forging ahead after the Medicare Advantage RADV Final RuleRaeAnn Grossman
Feb 6, 2023
QUALITY AND STARS
Closing the Gap: Improving cervical cancer preventionJamison Gillitzer
Jan 25, 2023
PAYMENT INTEGRITY
eBook: The payment integrity playbook for success in 2023 and beyondJordan Bazinsky
Jan 17, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching improper billing within genetic testing and molecular pathologyMelanie Poole
Dec 21, 2022
FRAUD, WASTE, AND ABUSE
Webinar: Deter FWA in 2023 with the latest investigative strategiesErin Rutzler
Nov 29, 2022
FRAUD, WASTE, AND ABUSE
Focusing on prepay FWA prevention at NHCAA's Annual Training ConferenceErin Rutzler
Nov 14, 2022
CONSUMER ENGAGEMENT
How payers can drive collaboration to support health equityLeah Dewey
Nov 8, 2022
RISK ADJUSTMENT
Webinar: How to build risk adjustment into your value-based care strategyJonas Foit
Nov 4, 2022
QUALITY AND STARS
Webinar: Optimize Medicare Advantage Star Ratings with Star IntelligenceAshley McNairy
Nov 1, 2022
PAYMENT INTEGRITY
3 key tips for managing your payment integrity portfolioJordan Bazinsky
Oct 24, 2022
RISK ADJUSTMENT
OIG risk adjustment compliance audit showcases 3 clear takeawaysRaeAnn Grossman
Oct 11, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Spotting overpayments in mental health servicesMelanie Poole
Sep 28, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching inappropriate billing within ASD servicesErin Rutzler
Sep 14, 2022
FRAUD, WASTE, AND ABUSE
SIU panel discussion: Best practices in healthcare payer FWAErin Rutzler
Sep 12, 2022
QUALITY AND STARS
Moving to in-year HEDIS: 5 best practices to boost scores and member engagementRaeAnn Grossman
Aug 30, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Spotting red flags in adult day care claimsErin Rutzler
Aug 18, 2022
QUALITY AND STARS
Podcast: Cotiviti SVP Rachael Jones on health equity strategyJeff Robinson
Aug 11, 2022
NETWORK AND CLINICAL ANALYTICS
On-demand webinar: Pursuing better value-based care with Florida Blue MedicareMary Srinivas
Aug 9, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging potential physical therapy schemesMelanie Poole
Aug 4, 2022
PAYMENT INTEGRITY
Video: How to shorten time to payment integrity resultsMatthew Hawley
Aug 3, 2022
QUALITY AND STARS
HEDIS® strategies: 4 ways to prepare for the ECDS transitionAshley McNairy
Jul 18, 2022
QUALITY AND STARS
Webinar: Reviewing HEDIS MY 2021 and looking ahead to MY 2022Jamison Gillitzer
Jun 30, 2022
PAYMENT INTEGRITY
3 key elements of a successful employment verification processNaomi Murphy
Jun 15, 2022
CONSUMER ENGAGEMENT
White paper: How to engage Medicaid members for more equitable outcomesRoberto Arce
Jun 8, 2022
PAYMENT INTEGRITY
FRAUD, WASTE, AND ABUSE
White paper: Detecting and preventing FWA in behavioral health claimsErin Rutzler
Jun 1, 2022
PAYMENT INTEGRITY
eBook: The payment integrity leader’s playbook for success in 2022 and beyondBrett Arnold
May 26, 2022
COTIVITI LEADERSHIP
Moving from surviving to thriving: 5 takeaways from CCC22 to improve U.S. healthcareJordan Bazinsky
May 19, 2022
NETWORK AND CLINICAL ANALYTICS
Podcast: The importance of interoperability in value-based careJeff Robinson
May 13, 2022
RISK ADJUSTMENT
OIG report highlights beneficiary protections as Medicare Advantage program growsRaeAnn Grossman and Jennifer Ach
May 6, 2022
PAYMENT INTEGRITY
Section 340B overview: Medicare, Medicaid, covered entities, and moreKristie Ressler, D.O.
May 3, 2022
RISK ADJUSTMENT
Medicare Advantage risk adjustment in 2022: Driving to fierce and focusedRaeAnn Grossman
Apr 21, 2022
NETWORK AND CLINICAL ANALYTICS
Podcast: Improving risk assessment for better care outcomesJeff Robinson
Apr 12, 2022
RISK ADJUSTMENT
5 takeaways from the 2023 Medicare Advantage and Part D Final Rate AnnouncementRaeAnn Grossman and Jennifer Ach
Apr 7, 2022
PAYMENT INTEGRITY
Specialty drugs: Why go beyond prior authorization?Jonathan Starr, PharmD
Mar 23, 2022
QUALITY AND STARS
NETWORK AND CLINICAL ANALYTICS
CONSUMER ENGAGEMENT
3 areas of investment for payers to improve health equity in 2022RaeAnn Grossman and Jennifer Ach
Mar 17, 2022
NETWORK AND CLINICAL ANALYTICS
Webinar: The path to adopting a successful Alternative Payment ModelMary Srinivas
Mar 15, 2022
QUALITY AND STARS
HEDIS MY 2023: Noteworthy topics to consider during NCQA’s public comment periodSamantha Davis
Mar 9, 2022
PAYMENT INTEGRITY
On-demand webinar: Beyond prior authorization: Ensuring accuracy of specialty drug claimsJonathan Starr, PharmD
Mar 2, 2022
QUALITY AND STARS
NCQA publishes proposed changes to HEDIS measures for MY 2023Samantha Davis
Feb 24, 2022
QUALITY AND STARS
CMS 2023 Advance Notice: Health equity takes center stageRaeAnn Grossman and Jennifer Ach
Feb 10, 2022
CONSUMER ENGAGEMENT
On-demand webinar: Meet your members where they are and move them to actRoberto Arce
Jan 26, 2022
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q4 2021Erin Rutzler
Jan 20, 2022
QUALITY AND STARS
COVID-19
Analysis: Behavioral health conditions, risk, and cost during the COVID-19 pandemicLeah Dewey
Dec 15, 2021
FRAUD, WASTE, AND ABUSE
What’s old is new again: 3 healthcare fraud trends to watch for in 2022Erin Rutzler
Dec 2, 2021
QUALITY AND STARS
CMS Innovation Center sharpens focus on health equity in new strategy refreshMary Srinivas
Nov 18, 2021
FRAUD, WASTE, AND ABUSE
Preparing your payment integrity programs for 2022 and beyondErin Rutzler
Nov 8, 2021