4 best practices to prevent rapid disenrollment for Medicare Advantage plans
Here are four proven best practices to remember as you build or improve upon your disenrollment prevention strategy.
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Cotiviti Blog
Cotiviti is empowering a sustainable value-based healthcare delivery and payment system for health plans, employers, and providers.
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Panel Webinar: Right payment integrity intervention, right time
An enterprise payment integrity strategy spanning the prepay and postpay continuum is essential to effective claims processing, provider relations, and cost savings. Healthcare payers...
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Boosting childhood vaccination rates amid a resurging pandemic
Routine pediatric immunizations are down worldwide. The World Health Organization and UNICEF reported that about 23 million children missed out on basic childhood vaccines last year—one...
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Podcast: Cotiviti CEO Emad Rizk, M.D. on payment integrity and interoperability
Cotiviti CEO Emad Rizk, M.D., joins The Incrementalist podcast for a conversation on how to turn healthcare waste into better patient care.
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On-demand Webinar: Moving beyond prepay vs. postpay
“Our preference has always been to get as much prepayment as we could, because it tends to be more efficient and create less hassle and frustration for the physicians who are usually...
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Video: Ensuring that healthcare data is shared ethically
To care for their members and patients, payers and providers must often share significant amounts of healthcare data across organizations—and ensure that data is protected and only...
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Busted: The top fraud schemes of Q2 2021
From fraudulent COVID-19 tests to fake requests for durable medical equipment (DME), this spring was full of attempts to defraud healthcare payers. Here, we’ve gathered some of the most...
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5 tips for improving and sustaining member satisfaction
With the HEDIS® season over and bids having been submitted for calendar year (CY) 2022, Medicare Advantage plans have a breather before summer enrollment education sessions, official...
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On-demand webinar: Staying active during a shorter HEDIS off-season
If there’s anything that we learned in 2020 and 2021, it’s the importance of being proactive. We understand better than ever that healthcare is dynamic, and our approach can’t be static...
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Redefining value: practical tactics to spur value-based care adoption
Payers and providers are both highly motivated to keep their members and patients healthy, but amid numerous challenges—not the least of which was the major disruption to primary care...
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Video: Improving efficiency across quality improvement teams
With the June 15 submission deadline just over a month away, health plan quality departments are in the thick of the HEDIS® Measurement Year (MY) 2020 audits and submissions. But soon,...
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Q&A: Strategic payer initiatives at the intersection of risk and quality
By working in unison, risk adjustment and quality teams can better understand where care gaps exist and the most effective ways to deliver high-value care to disengaged or disenfranchised members.
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Busted: The top healthcare fraud schemes of Q1 2021
While 2021 has brought renewed optimism over the COVID-19 pandemic, it has also delivered numerous new fraud, waste, and abuse (FWA) cases in healthcare.
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Q&A: Improving value-based care through data and collaboration
To successfully transition from paying for volume to paying for value, Medicare Advantage plans must take a more innovative approach to provider engagement.
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Podcast: The role of AI during COVID-19 and in a post-pandemic world
While COVID-19 has shifted many healthcare payers' priorities in the past year, organizations are also looking at where they will make their long-term technology investments once the...
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How to turn in-home assessments into “close encounters of the right kind”
Health plans complete in-home health assessments (often called health risk assessments) for their members for several reasons: accurately documenting members’ risk burden, supporting...
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Keeping members in mind: Optimizing coordination of benefits
Coordination of benefits (COB) requires health plans to navigate significant complexities. The order of benefit determination rules rely on an ever-changing member landscape that is as...
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NCQA publishes proposed changes to HEDIS measures for MY 2022
The National Committee for Quality Assurance (NCQA) is accepting comments through March 11 on proposed changes for HEDIS® Measurement Year 2022 (MY 2022), which will be published in...
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Case study: Identifying potential fraud, waste, and abuse during the COVID-19 pandemic
While the COVID-19 pandemic has challenged providers in significant ways, it unfortunately has also created new opportunities for a small handful of bad actors to take advantage of the...
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CMS Star Ratings: Navigating changes in 2021 and the coming years
As many health plans know, achieving a higher Star Rating will soon be more challenging. The Centers for Medicare & Medicaid Services (CMS) is changing the makeup of the rating system,...
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