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Our latest healthcare insights and perspectives

PAYMENT INTEGRITY

The practical landscape of AI in payment integrity and VBP

Brett Arnold

Nov 5, 2025

Latest Content

FRAUD, WASTE, AND ABUSE

FWA Insights: Stopping “phantom providers” with prepay intervention

Erin Rutzler

Nov 3, 2025

QUALITY AND STARS

2026 Star Ratings: What they mean and what comes next

Marge Ciancetta

Oct 29, 2025

PAYMENT INTEGRITY

Case Study: Regional Blue Plan performs beyond hype with Data Mining

Kevin Laskey

Oct 23, 2025

RISK ADJUSTMENT

Webinar: Navigating 2026 coding updates for risk adjustment success

Katie Sender, MSN, RN, PHN, CRC

Oct 21, 2025

Popular

01

Busted: The top fraud schemes of Q2 2025

Erin Rutzler

Sep 25, 2025

02

Busted: The top healthcare fraud schemes of Q4 2024

Erin Rutzler

Mar 19, 2025

03

FWA Insights: Solving durable medical equipment (DME) challenges

Yolanda Wilson, MPH, CPC

May 13, 2025

04

Busted: The top fraud schemes of Q1 2025

Erin Rutzler

Apr 30, 2025

QUALITY AND STARS

NCQA releases proposed HEDIS MY 2025 updates

Samantha Davis

Feb 28, 2024

QUALITY AND STARS

NCQA confirms HEDIS® updates for Measurement Year (MY) 2024

Samantha Davis

Sep 18, 2023

QUALITY AND STARS

Summary: NCQA releases proposed HEDIS changes for MY 2024 and MY 2025

Samantha Davis

Feb 23, 2023

QUALITY AND STARS

HEDIS MY 2023: Noteworthy topics to consider during NCQA’s public comment period

Samantha Davis

Mar 9, 2022

QUALITY AND STARS

NCQA publishes proposed changes to HEDIS measures for MY 2023

Samantha Davis

Feb 24, 2022

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