CCC25: 3 key pillars required to perform beyond healthcare challenges
As health plan leaders in quality improvement, risk adjustment, and payment integrity gathered for the Cotiviti Client Conference 2025 (CCC25) last month, the phrase “unprecedented change” factored into many sessions and conversations. As payers look to keep up with shifting federal regulations impacting their risk adjustment programs, demographic and medical drug trends impacting their sustainability, challenges around digital data access and more, they often look for partners to help supplement their in-house teams.
As always, many of the most valuable takeaways of the conference came not just from the formal presentations, but informational conversations and feedback from Cotiviti’s customers. Here are three key values we heard about most frequently throughout CCC25 that are an increasingly vital component of performing beyond the persistent challenges in our healthcare system.
Transparency: A prerequisite for trust
When asked what makes a vendor easy to work with during our pre-conference networking session, one of the first attributes our clients mentioned was transparency. For healthcare partners like Cotiviti, this translates into a willingness to support provider and consumer transparency through improvement in reporting and data sharing.
For our health plan clients themselves, transparency with providers and members is becoming increasingly important as well. As one quality leader mentioned during a client panel discussion, when her organization struggled with provider appeals, her plan revamped its approach to provider communications, offering much clearer explanations and rationale as to why a claim did not meet payment criteria and leading to better outcomes for the provider and member. By taking a more collaborative approach to transparency, healthcare stakeholders can avoid surprises that could impact provider delivery and member care.
Authenticity: A core differentiator in the age of artificial intelligence
In an era where every healthcare technology vendor offers solutions driven by artificial intelligence and machine learning, clinical expertise is increasingly becoming a crucial differentiator. As Cotiviti President and CEO Emad Rizk, M.D., mentioned during a keynote presentation, AI is only as good as the knowledge, concepts, and data behind it.
Payers can only trust automated, AI-driven solutions when they know that human expertise is driving and overseeing those solutions. While AI is a vital tool for Cotiviti that drives efficiency in areas such as chart selection, which reduces the number of medical records requests sent to providers, it is not used to make payment decisions or replace clinical and operational expertise. Cotiviti has deployed AI, machine learning, advanced analytics, and automation technology to improve solutions and outcomes.
Accountability: The ultimate indicator of value
Another takeaway from the pre-conference discussion was that our healthcare clients expect us to be one step ahead of them, not behind them. Whether we’re breaking down Medicare risk adjustment changes from the Centers for Medicare & Medicaid Services (CMS) or integrating new state-level quality measures into our solutions, it’s our responsibility to be a proactive partner to health plans, not reactive. During a breakout session on preventing and managing fraud, waste, and abuse, it was gratifying to hear one client mention that Cotiviti’s team acts as an extension of her plan’s special investigations unit (SIU), mimicking her team’s own internal processes and following industry standards to achieve the best investigative outcomes.
As our closing keynote speaker noted during her talk on igniting organizational accountability, simply performing a task is not equal to achieving a desirable result. You must dig a few layers deeper, understanding the beliefs and experiences of individuals. As a partner to payers of all sizes, we strive to be accountable for performing beyond the expectations of our healthcare clients. At Cotiviti, this means delivering total value, meaningful innovation, and deep expertise that benefit our clients’ most critical programs—and ultimately every stakeholder in our healthcare ecosystem, including patients and members.
We are deeply grateful to our clients for actively participating in our annual client conference—and for holding us to high standards that enable Cotiviti to help deliver a high-quality and viable healthcare system.
Above all at Cotiviti, we pledge to deliver value to our clients with integrity. Read our Cotiviti Client Pledge and learn how we’re committed to improving our clients’ performance.
