latest content

featured content

filter by categories

how consumers, employers, and the government are coming “off the sidelines” in value-based...

While collaboration between payers and providers is the most crucial component of delivering better care at lower cost i...

the three fundamentals of risk adjustment success

The term “risk adjustment” means different things to different people depending on their role. The Centers for Medicare ...

payer-provider collaboration tools: a state of the union

The imperative for payers and providers to collaborate in a systematic way has never been stronger. But while technologi...

the twin engines of clinical validation

Advanced analytics applied by an automated claim editing system are crucial for identifying claims that are potentially ...

reflections from a healthcare IT “up-and-comer”

Wednesday, Becker’s Hospital Review recognized Verscend’s Jordan Bazinsky, executive vice president of product and strat...

busted: rounding up the top fraud schemes of Q2 2018

The nation’s top special investigators and law enforcement officials were hard at work stamping out the weeds of healthc...

breaking it down: CMS reinstates ACA risk adjustment payments

On Tuesday, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that enables the federal government t...

podcast: how risk adjustment coding validation gives health plans more certainty

Compliance is becoming an increasingly difficult challenge for Medicare Advantage plans, especially when it comes to the...

crunching the numbers as ACA risk adjustment transfer payments are put on hold

On Monday, the Centers for Medicare & Medicaid Services (CMS) released the health plan-specific 2017 benefit year risk a...

podcast: navigating to better Star Ratings performance

You’ve submitted your final data to NCQA and CMS, marking the end of the HEDIS® 2018 marathon. Now it’s on to the next c...

don’t miss an update

leave a comment below: