Analytics To The Rescue: Helping Brokers Answer Health Insurance ROI Queries

June 05 2018 | by David Hom in Health Analytics

Employers typically aim to hold health insurance investment costs down while also enhancing employee health programs to experience improved recruitment/retention, employee productivity and overall satisfaction.


Custom concept development: The key to overpayment recovery ROI

May 30 2018 | by Lalithya Yerramilli in Payment Integrity

This post originally appeared on SmartBrief's Leadership Blog.

It seems simple. Health insurers receive a bill for medical care and make the payment. Yet, payment integrity has long posed a challenge in health care. Although health plans have made substantial progress, in 2014, they were still over- or under-paying claims 9.5% of the time.[1] Consequences include health care provider abrasion, wasted spending and investment in resources to recoup excess payments.


Making Progress? Poll Participants Assess Value-Based Care Efforts

May 24 2018 | by SCIO Health Analytics in Health Analytics

During a recent webinar entitled “Key Levers to Manage The ‘Risk’ in Your Risk-based Contracts,” Rose Higgins, President, SCIO Health Analytics, described how healthcare organizations can succeed under value-based care arrangements by identifying/closing care gaps, implementing population health programs and optimizing network performance. And, Linda Pantovic, Director of Compliance & Risk Adjustment at Scripps Health Plan Services, offered an up-close look at how Scripps is mitigating risk across their organization by focusing on key documentation and coding best practices.


Patient Engagement: 3 Ways to Rise Above the Electronic Noise

May 22 2018 | by Arun Rangamani and Priyanka Rajkumar in Health Analytics

Electronic communication is all pervasive in today’s world. Not surprisingly, healthcare organizations and their patients/ members want to communicate via smartphones and other mobile devices. What they don’t want, however, is a lot of electronic noise.


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President, Niloff Healthcare Strategies, LLC


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Lesli Adams, MPA (Guest Author)
Director of Population Health Strategy, Oracle Corporation


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Director of Compliance & Risk Adjustment, Scripps Health Plan Services


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