Our latest healthcare insights and perspectives
PAYMENT INTEGRITY
Podcast: The "Total Value" approach to payment integrityJeff Robinson
Mar 26, 2024
RISK ADJUSTMENT
New approaches to enhance risk adjustment at RISE National 2024Katie Sender, MSN, RN, PHN, CRC
Mar 5, 2024
RISK ADJUSTMENT
RISE Webinar: Key risk adjustment trends to watch in 2024Branka Sustic
Feb 26, 2024
QUALITY AND STARS
Quality Decoded webinar series: 2025 CMS Advance NoticeMarge Ciancetta
Feb 20, 2024
Melanie Poole
Aug 2, 2023
QUALITY AND STARS
RISK ADJUSTMENT
3 interoperability updates for payers in 2024Katie Devlin, DHSc, MS, CPHIMS
Feb 14, 2024
QUALITY AND STARS
RISK ADJUSTMENT
3 takeaways from the 2025 Advance NoticeBranka Sustic
Feb 8, 2024
FRAUD, WASTE, AND ABUSE
FWA Insights: Examining a suspicious volume of HCPCS codesMelanie Poole
Jan 31, 2024
PAYMENT INTEGRITY
White paper: Improving payment integrity with inpatient claim reviewCheri Moehring
Jan 29, 2024
FRAUD, WASTE, AND ABUSE
Case study: Integrated prepay and FWA solutions deliver improved claim accuracyVince Smith, AHFI, CFE
Jan 24, 2024
FRAUD, WASTE, AND ABUSE
Preparing for 2024 trends in healthcare FWA: CPT code updates and beyondMary Cate Anderson, HCAFA
Jan 17, 2024
ENTERPRISE DATA ANALYTICS
Best of 2023: Explore Cotiviti’s top content from last yearJeff Robinson
Jan 9, 2024
FRAUD, WASTE, AND ABUSE
Webinar: Preparing for investigative strategies in 2024Mary Cate Anderson, HCAFA
Dec 5, 2023
CONSUMER ENGAGEMENT
Case study: Reaching Medicaid members amid redeterminationLeah Dewey
Nov 30, 2023
QUALITY AND STARS
Closing the Gap: Improving chronic disease screening and careJamison Gillitzer
Nov 28, 2023
PAYMENT INTEGRITY
Case study: Data mining for errors yields more accurate pharmacy paymentsMatthew Herbein
Nov 16, 2023
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q3 2023Erin Rutzler
Nov 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging suspicious activity related to COVID-19 testingErin Rutzler
Nov 8, 2023
CONSUMER ENGAGEMENT
Video: Reducing disparities in care during Global Health Equity WeekKassi Yozzo
Oct 26, 2023
QUALITY AND STARS
Closing the Gap: Better preventative measures for breast cancerAshley McNairy
Sep 28, 2023
QUALITY AND STARS
White paper: Implementing a digital quality strategyKatie Devlin, DHSc, MS, CPHIMS
Sep 20, 2023
QUALITY AND STARS
NCQA confirms HEDIS® updates for Measurement Year (MY) 2024Samantha Davis
Sep 18, 2023
PAYMENT INTEGRITY
Savings spotlight: Dental claim review expertise nets significant savingsSteve Canfield, DDS
Sep 13, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Finding new schemes with AI and investigative techniquesErin Rutzler
Sep 11, 2023
QUALITY AND STARS
Podcast: Enhancing interoperability for better risk and quality outcomesKassi Yozzo
Sep 6, 2023
QUALITY AND STARS
Closing the Gap: Maintaining healthy cholesterol and improving medication adherenceMatt Simon
Aug 31, 2023
PAYMENT INTEGRITY
Podcast: Payment integrity for self-insured (ASO) employer groupsJeff Robinson
Aug 16, 2023
PAYMENT INTEGRITY
Video: A new approach to prepay coordination of benefits (COB) validationNaomi Murphy
Aug 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutidesMelanie Poole
Aug 2, 2023
QUALITY AND STARS
Closing the Gap: National Immunization Awareness MonthJamison Gillitzer
Jul 31, 2023
QUALITY AND STARS
Navigating changes in Star Ratings programs: Enhancing success with four key stepsMarge Ciancetta
Jul 24, 2023
PAYMENT INTEGRITY
Webinar: Making payment integrity work for your self-insured groupsAllyn Sullivan
Jul 19, 2023
PAYMENT INTEGRITY
4 strategies to curb medical cost increases as healthcare utilization reboundsMatthew Hawley
Jul 10, 2023
QUALITY AND STARS
Closing the Gap: Minority Mental Health AwarenessKatie Devlin, DHSc, MS, CPHIMS
Jun 29, 2023
CONSUMER ENGAGEMENT
Podcast: Preventing coverage loss during redeterminationJeff Robinson
Jun 14, 2023
QUALITY AND STARS
Preparing for a “Universal Foundation” of quality measuresBranka Sustic
Jun 12, 2023
FRAUD, WASTE, AND ABUSE
How to sequence FWA investigations for greater impactErin Rutzler
Jun 7, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging high-frequency telehealth claimsErin Rutzler
Jun 1, 2023
QUALITY AND STARS
Webinar: Optimizing MA Star Ratings with Star IntelligenceAshley McNairy
May 23, 2023
PAYMENT INTEGRITY
White paper: The “smart prepay” approach to payment integrityMatthew Hawley
Apr 20, 2023
QUALITY AND STARS
CONSUMER ENGAGEMENT
Closing the Gap: National Minority Health MonthLeah Dewey
Apr 17, 2023
PAYMENT INTEGRITY
Savings spotlight: Cotiviti takes on payment integrity in 5 new case studiesWarren Lesnefsky
Apr 3, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Prepay review leads to >$100K in projected annual savingsErin Rutzler
Mar 28, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Sequencing investigative activities for greater provider impactErin Rutzler
Mar 22, 2023
QUALITY AND STARS
Closing the Gap: Improve screening rates during Colorectal Cancer Awareness MonthThelma Belli
Mar 21, 2023
FRAUD, WASTE, AND ABUSE
Podcast: How health plans investigate and prevent FWAJeff Robinson
Mar 2, 2023
QUALITY AND STARS
Summary: NCQA releases proposed HEDIS changes for MY 2024 and MY 2025Samantha Davis
Feb 23, 2023
QUALITY AND STARS
Closing the Gap: Preventative measures for better heart healthAshley McNairy
Feb 21, 2023
QUALITY AND STARS
Rounding up Star Ratings changes in the 2024 Advance NoticeAshley McNairy
Feb 16, 2023
QUALITY AND STARS
Closing the Gap: Improving cervical cancer preventionJamison Gillitzer
Jan 25, 2023
PAYMENT INTEGRITY
eBook: The payment integrity playbook for success in 2023 and beyondJordan Bazinsky
Jan 17, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching improper billing within genetic testing and molecular pathologyMelanie Poole
Dec 21, 2022
FRAUD, WASTE, AND ABUSE
Webinar: Deter FWA in 2023 with the latest investigative strategiesErin Rutzler
Nov 29, 2022
FRAUD, WASTE, AND ABUSE
Focusing on prepay FWA prevention at NHCAA's Annual Training ConferenceErin Rutzler
Nov 14, 2022
CONSUMER ENGAGEMENT
How payers can drive collaboration to support health equityLeah Dewey
Nov 8, 2022
RISK ADJUSTMENT
Webinar: How to build risk adjustment into your value-based care strategyJonas Foit
Nov 4, 2022
QUALITY AND STARS
Webinar: Optimize Medicare Advantage Star Ratings with Star IntelligenceAshley McNairy
Nov 1, 2022
PAYMENT INTEGRITY
3 key tips for managing your payment integrity portfolioJordan Bazinsky
Oct 24, 2022
RISK ADJUSTMENT
OIG risk adjustment compliance audit showcases 3 clear takeawaysCotiviti
Oct 11, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Spotting overpayments in mental health servicesMelanie Poole
Sep 28, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching inappropriate billing within ASD servicesErin Rutzler
Sep 14, 2022
FRAUD, WASTE, AND ABUSE
SIU panel discussion: Best practices in healthcare payer FWAErin Rutzler
Sep 12, 2022
QUALITY AND STARS
Moving to in-year HEDIS: 5 best practices to boost scores and member engagementCotiviti
Aug 30, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Spotting red flags in adult day care claimsErin Rutzler
Aug 18, 2022
QUALITY AND STARS
Podcast: Cotiviti SVP Rachael Jones on health equity strategyJeff Robinson
Aug 11, 2022
NETWORK AND CLINICAL ANALYTICS
On-demand webinar: Pursuing better value-based care with Florida Blue MedicareMary Srinivas
Aug 9, 2022
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging potential physical therapy schemesMelanie Poole
Aug 4, 2022
PAYMENT INTEGRITY
Video: How to shorten time to payment integrity resultsMatthew Hawley
Aug 3, 2022
QUALITY AND STARS
HEDIS® strategies: 4 ways to prepare for the ECDS transitionAshley McNairy
Jul 18, 2022
QUALITY AND STARS
Webinar: Reviewing HEDIS MY 2021 and looking ahead to MY 2022Jamison Gillitzer
Jun 30, 2022
PAYMENT INTEGRITY
3 key elements of a successful employment verification processNaomi Murphy
Jun 15, 2022
CONSUMER ENGAGEMENT
White paper: How to engage Medicaid members for more equitable outcomesRoberto Arce
Jun 8, 2022
PAYMENT INTEGRITY
FRAUD, WASTE, AND ABUSE
White paper: Detecting and preventing FWA in behavioral health claimsErin Rutzler
Jun 1, 2022
PAYMENT INTEGRITY
eBook: The payment integrity leader’s playbook for success in 2022 and beyondBrett Arnold
May 26, 2022
COTIVITI LEADERSHIP
Moving from surviving to thriving: 5 takeaways from CCC22 to improve U.S. healthcareJordan Bazinsky
May 19, 2022
NETWORK AND CLINICAL ANALYTICS
Podcast: The importance of interoperability in value-based careJeff Robinson
May 13, 2022
RISK ADJUSTMENT
OIG report highlights beneficiary protections as Medicare Advantage program growsCotiviti
May 6, 2022
PAYMENT INTEGRITY
Section 340B overview: Medicare, Medicaid, covered entities, and moreKristie Ressler, D.O.
May 3, 2022
RISK ADJUSTMENT
Medicare Advantage risk adjustment in 2022: Driving to fierce and focusedCotiviti
Apr 21, 2022
NETWORK AND CLINICAL ANALYTICS
Podcast: Improving risk assessment for better care outcomesJeff Robinson
Apr 12, 2022
RISK ADJUSTMENT
5 takeaways from the 2023 Medicare Advantage and Part D Final Rate AnnouncementCotiviti
Apr 7, 2022
PAYMENT INTEGRITY
Specialty drugs: Why go beyond prior authorization?Jonathan Starr, PharmD
Mar 23, 2022
QUALITY AND STARS
NETWORK AND CLINICAL ANALYTICS
CONSUMER ENGAGEMENT
3 areas of investment for payers to improve health equity in 2022Cotiviti
Mar 17, 2022
NETWORK AND CLINICAL ANALYTICS
Webinar: The path to adopting a successful Alternative Payment ModelMary Srinivas
Mar 15, 2022
QUALITY AND STARS
HEDIS MY 2023: Noteworthy topics to consider during NCQA’s public comment periodSamantha Davis
Mar 9, 2022
PAYMENT INTEGRITY
On-demand webinar: Beyond prior authorization: Ensuring accuracy of specialty drug claimsJonathan Starr, PharmD
Mar 2, 2022
QUALITY AND STARS
NCQA publishes proposed changes to HEDIS measures for MY 2023Samantha Davis
Feb 24, 2022
QUALITY AND STARS
CMS 2023 Advance Notice: Health equity takes center stageRaeAnn Grossman and Jennifer Ach
Feb 10, 2022
CONSUMER ENGAGEMENT
On-demand webinar: Meet your members where they are and move them to actRoberto Arce
Jan 26, 2022
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q4 2021Erin Rutzler
Jan 20, 2022
QUALITY AND STARS
COVID-19
Analysis: Behavioral health conditions, risk, and cost during the COVID-19 pandemicLeah Dewey
Dec 15, 2021
FRAUD, WASTE, AND ABUSE
What’s old is new again: 3 healthcare fraud trends to watch for in 2022Erin Rutzler
Dec 2, 2021
QUALITY AND STARS
CMS Innovation Center sharpens focus on health equity in new strategy refreshMary Srinivas
Nov 18, 2021
FRAUD, WASTE, AND ABUSE
Preparing your payment integrity programs for 2022 and beyondErin Rutzler
Nov 8, 2021
PAYMENT INTEGRITY
3 reasons retrospective solutions are a vital part of claims payment integritySusan Murray
Nov 3, 2021
CONSUMER ENGAGEMENT
Podcast: Welcoming, onboarding, and retaining members in the new yearJeff Robinson
Nov 1, 2021
RISK ADJUSTMENT
RISE Webinar: Uniting risk adjustment, HEDIS, and Star Ratings initiativesJonas Foit
Oct 28, 2021
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q3 2021Erin Rutzler
Oct 26, 2021
QUALITY AND STARS
Learning from 2022 Star Ratings and planning for 2023–2024Ashley McNairy
Oct 19, 2021
CONSUMER ENGAGEMENT
Staving off the “twindemic” by boosting flu immunization ratesJennifer Forster
Oct 6, 2021
PAYMENT INTEGRITY
E&M over-coding: How can payers solve this costly challenge?Richard Pozen, M.D.
Sep 29, 2021
PAYMENT INTEGRITY
Execute healthcare claims editing more accurately—with less provider abrasionMatthew Hawley
Sep 22, 2021
CONSUMER ENGAGEMENT
4 best practices to prevent rapid disenrollment for Medicare Advantage plansAnne L. Davis
Sep 15, 2021
PAYMENT INTEGRITY
On-demand panel webinar: Right payment integrity intervention, right timeMichael Jablon
Aug 31, 2021
CONSUMER ENGAGEMENT
Boosting childhood vaccination rates amid a resurging pandemicJennifer Forster
Aug 19, 2021
PAYMENT INTEGRITY
Podcast: Cotiviti CEO Emad Rizk, M.D. on payment integrity and interoperabilityJeff Robinson
Aug 4, 2021
ENTERPRISE DATA ANALYTICS
Video: Ensuring that healthcare data is shared ethicallyJeff Robinson
Jul 26, 2021
CONSUMER ENGAGEMENT
5 tips for improving and sustaining member satisfactionAnne L. Davis
Jul 15, 2021
QUALITY AND STARS
On-demand webinar: Staying active during a shorter HEDIS off-seasonBranka Sustic
Jul 13, 2021
PAYMENT INTEGRITY
The right payment solution at the right time: 3 takeaways from Cotiviti’s new researchJordan Bazinsky
Jul 8, 2021
NETWORK AND CLINICAL ANALYTICS
3 strategies to boost payer-provider collaboration amid COVID-19Jeff Robinson
Jun 17, 2021
NETWORK AND CLINICAL ANALYTICS
Redefining value: practical tactics to spur value-based care adoptionLeah Dewey
Jun 10, 2021
PAYMENT INTEGRITY
On-demand webinar: Integrating pre and postpay programs for optimal FWA resultsErin Rutzler
May 19, 2021
QUALITY AND STARS
Video: Improving efficiency across quality improvement teamsDavid Wolf
May 13, 2021
RISK ADJUSTMENT
Q&A: Strategic payer initiatives at the intersection of risk and qualityDavid Costello
May 11, 2021
FRAUD, WASTE, AND ABUSE
Busted: The top healthcare fraud schemes of Q1 2021Erin Rutzler
Apr 15, 2021
NETWORK AND CLINICAL ANALYTICS
Q&A: Improving value-based care through data and collaborationMary Srinivas
Apr 6, 2021
ENTERPRISE DATA ANALYTICS
Podcast: The role of AI during COVID-19 and in a post-pandemic worldJeff Robinson
Mar 31, 2021
PAYMENT INTEGRITY
Keeping members in mind: Optimizing coordination of benefitsNaomi Murphy
Mar 23, 2021
QUALITY AND STARS
NCQA publishes proposed changes to HEDIS measures for MY 2022Jamison Gillitzer
Mar 2, 2021
QUALITY AND STARS
Cotiviti achieves 20 years of HEDIS® certification amid expanding quality landscapeJeff Robinson
Feb 25, 2021
NETWORK AND CLINICAL ANALYTICS
On-demand webinar: Improving value-based care through data-driven insights—lessons from Florida Blue MedicareRachael Jones
Feb 22, 2021
QUALITY AND STARS
CMS Star Ratings: Navigating changes in 2021 and the coming yearsAshley McNairy
Feb 16, 2021
Naomi Murphy
Jan 20, 2021
COVID-19
COVID-19 health risk by underlying condition and age: what the latest data saysShyamali Mukerjee
Jan 11, 2021
COTIVITI LEADERSHIP
3 predictions for healthcare in 2021 from Cotiviti CEO Emad Rizk, M.D.Jeff Robinson
Dec 21, 2020
COVID-19
Video: Forecasting COVID-19 outbreaks in Massachusetts and beyondJeff Robinson
Dec 4, 2020
PAYMENT INTEGRITY
Podcast: Dr. Emad Rizk on managing telehealth concerns amid COVID-19Tom Betar
Nov 24, 2020
QUALITY AND STARS
Precision medicine’s value to complex disease managementShyamali Mukerjee
Nov 3, 2020
COVID-19
PAYMENT INTEGRITY
Case study: Identifying potential fraud, waste, and abuse during the COVID-19 pandemicErin Rutzler
Oct 27, 2020
QUALITY AND STARS
Cotiviti clients outperform the field in 2021 Star RatingsAshley McNairy
Oct 14, 2020
COVID-19
Dr. Emad Rizk: Why analytics-driven interoperability is vital in 2020 and beyondJeff Robinson
Oct 6, 2020
NETWORK AND CLINICAL ANALYTICS
Case study: Accelerating value-driven care through provider specialty tieringMac Davis
Oct 2, 2020
COTIVITI LEADERSHIP
COVID-19
Video: Cotiviti CEO Emad Rizk, M.D., on the current state of interoperabilityTom Betar
Sep 16, 2020
RISK ADJUSTMENT
CMS releases ACA risk adjustment transfer payments and HRADV adjustments for 2019David Wolf
Sep 14, 2020
ENTERPRISE DATA ANALYTICS
Podcast: Cotiviti SVP Rachael Jones on the power of predictive dataTom Betar
Sep 10, 2020
COTIVITI LEADERSHIP
Video: Cotiviti VP Nicole Neumarker on practical applications of AI in healthcareTom Betar
Aug 28, 2020
COTIVITI LEADERSHIP
Podcast: Cotiviti's Jordan Bazinsky on the state of payer dataJeff Robinson
Aug 20, 2020
COVID-19
PAYMENT INTEGRITY
Q&A: Highmark's payment integrity director on new COVID-19 claim trendsMichael Jablon
Aug 17, 2020
COTIVITI LEADERSHIP
Five ways to disrupt U.S. healthcare from Cotiviti’s Jordan BazinskyTom Betar
Aug 11, 2020
QUALITY AND STARS
Q&A: How Arkansas Blue Cross created a value-based payment modelRachael Jones
Aug 5, 2020
COVID-19
Rolling back the surge: new Cotiviti map helps forecast COVID-19 health risk severityJoshua Uda
Jul 30, 2020
MEDICAID
COVID-19
PAYMENT INTEGRITY
Five critical areas of focus for Medicaid plans amid COVID-19Bonnie Phillips
Jul 15, 2020
COVID-19
PAYMENT INTEGRITY
Busted: the top COVID-19 healthcare fraud schemesErin Rutzler
Jul 13, 2020
QUALITY AND STARS
COVID-19
Webinar: Turning the page on this year's HEDIS seasonBranka Sustic
Jul 2, 2020
RISK ADJUSTMENT
Mitigating the impact of COVID-19 on risk adjustment and quality scoresAshley McNairy
Jun 26, 2020
COVID-19
PAYMENT INTEGRITY
Video: Preventing healthcare fraud, waste, and abuse before paying claimsErin Rutzler
Jun 24, 2020
ENTERPRISE DATA ANALYTICS
COVID-19
How COVID-19 has highlighted the urgency of interoperabilityTom Betar
Jun 18, 2020
PAYMENT INTEGRITY
Webinar: Achieving payment integrity success amid COVID-19Michelle DeNetto, M.D.
Jun 11, 2020
ENTERPRISE DATA ANALYTICS
Preparing for the aftermath: collecting COVID-19 analytic insightsRachael Jones
Jun 9, 2020
COTIVITI LEADERSHIP
COVID-19
Video: CEO Emad Rizk, M.D. on Cotiviti's COVID-19 Outbreak TrackerTom Betar
May 27, 2020
RISK ADJUSTMENT
Laying the foundation for commercial risk adjustment success amid COVID-19Rebecca Darnall
May 21, 2020
QUALITY AND STARS
How employers can use claims data to address opioid addictionTom Betar
May 18, 2020
COTIVITI LEADERSHIP
COVID-19
Navigating data sharing and patient privacy amid public health crisesTom Betar
Apr 24, 2020
COVID-19
Cotiviti leverages the predictive power of data to respond to COVID-19Joshua Uda
Apr 20, 2020
COVID-19
CMS bumps Medicare Advantage growth rate amid COVID-19 outbreakRebecca Darnall
Apr 7, 2020
COVID-19
COVID-19 claim editing: coding resources for health plansMichelle DeNetto, M.D.
Apr 1, 2020