Our latest healthcare insights and perspectives
FRAUD, WASTE, AND ABUSE
FWA Insights: Solving durable medical equipment (DME) challengesYolanda Wilson, MPH, CPC
May 13, 2025
PAYMENT INTEGRITY
Payment integrity: Unlocking the value of complex outpatient reviewsAmy Carleton, RN, BSN
May 7, 2025
QUALITY AND STARS
RISK ADJUSTMENT
3 updates from the 2026 CMS Final Rate AnnouncementBranka Sustic
Apr 14, 2025
QUALITY AND STARS
From the HEDIS® 2019 trenches: tracking your retrieval and abstraction effortsJenna Fitcher
Mar 20, 2019
ENTERPRISE DATA ANALYTICS
Podcast: A path to success in the changing data management landscapeJeff Robinson
Mar 12, 2019
QUALITY AND STARS
Looking ahead: proposed measure changes for HEDIS® 2020Jamison Gillitzer
Mar 6, 2019
RISK ADJUSTMENT
How to stay sharp during commercial risk adjustment seasonRebecca Darnall
Feb 28, 2019
QUALITY AND STARS
From the HEDIS® 2019 trenches: optimizing your chasesLeah Breeggemann
Feb 20, 2019
ENTERPRISE DATA ANALYTICS
Podcast: improving healthcare tech for a 360° view of patient careJeff Robinson
Feb 12, 2019
QUALITY AND STARS
From the HEDIS® 2019 trenches: getting your data in orderJamison Gillitzer
Jan 24, 2019
ENTERPRISE DATA ANALYTICS
What should payers consider before diving into a data lake?Jeff Robinson
Jan 17, 2019
PAYMENT INTEGRITY
Busted: rounding up the top fraud schemes of Q3-Q4 2018Warren Lesnefsky
Jan 10, 2019
RISK ADJUSTMENT
Beneficiary-specific risk adjustment: proposed 2020 Medicare Advantage risk adjustment model changesLesley Brown
Jan 4, 2019
QUALITY AND STARS
Achieving five-star success: takeaways from the Medicare Star Ratings & Quality Assurance SummitAshley McNairy
Dec 13, 2018
PAYMENT INTEGRITY
Podcast: How clinical validation is good for payers, providers, and patientsJeff Robinson
Sep 27, 2018
Jeff Robinson
Sep 19, 2018
RISK ADJUSTMENT
Breaking it down: CMS reinstates ACA risk adjustment paymentsRebecca Darnall
Jul 25, 2018
RISK ADJUSTMENT
Crunching the numbers as ACA risk adjustment transfer payments are put on holdLesley Brown
Jul 11, 2018
RISK ADJUSTMENT
Suspecting analytics transformed—the rapid movement from clinical rules to machine learningDavid Costello
May 30, 2018
ENTERPRISE DATA ANALYTICS
Set your data free! Takeaways from the 2018 Health DatapaloozaDavid Costello
May 3, 2018
QUALITY AND STARS
Podcast: Are you ready for medical record review validation?Jeff Robinson
Apr 24, 2018
RISK ADJUSTMENT
Podcast: Sifting the 2019 Medicare Advantage Final Rate NoticeJeff Robinson
Apr 6, 2018
QUALITY AND STARS
From the trenches podcast: HEDIS® measure changes on the horizonJeff Robinson
Mar 28, 2018
QUALITY AND STARS
From the trenches podcast: The changing quality improvement landscapeJeff Robinson
Feb 14, 2018
QUALITY AND STARS
from the trenches podcast: prepping for HEDIS® 2018 productionJeff Robinson
Jan 30, 2018
ENTERPRISE DATA ANALYTICS
What makes Verscend a “major player” in clinical and financial analytics?Jordan Bazinsky
Jan 23, 2018
PAYMENT INTEGRITY
Get more bang for your buck with claim editing analyticsJonathan Edwards
Jan 17, 2018
RISK ADJUSTMENT
Breaking it down: proposed Medicare Advantage risk adjustment model changes for 2019Lesley Brown
Jan 11, 2018