Newsletters

01.27.20

Expanding Payer and Provider Participation in Data Exchange

Health information exchange (HIE) is vital to enabling the quadruple aim of better care, better health, improved clinician experience and lower costs.


02.21.18

Hospitals and Health Systems Prepare for a Value-Based Future

There are six key drivers of the movement to a risk-based healthcare environment:


01.25.18

The Eight Key Elements of Effective Compliance Programs

Mandated compliance programs are not a new concept, but they have evolved over time.


12.18.17

Part 1: Megatrends Reinventing How Patients Think

In early 2017, California Assembly member Jim Wood introduced Bill AB-265, banning the use of copay coupons in California when a generic equivalent drug covered by an individual’s health plan exists.


11.21.17

Fraud and Abuse 2017: Understanding Trends and Avoiding Actions

Under the Trump administration, healthcare fraud will remain a key focus.


10.27.17

Communities in Crisis: Local Responses to Behavioral Health Challenges

The dual challenge of America’s growing opioid epidemic and SMI is having a devastating impact on communities nationwide.


10.20.16

Defining and Resolving the Provider Data Dilemma

The healthcare system is undergoing massive transformation, including new insurance marketplaces, expanded public and commercial coverage, rapid digitalization and emerging value-based regulatory and payment reforms.


06.23.16

Real-Time Data Analytics in Government Investigations and Reducing Exposure

It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet, after studying the playbook of sophisticated corporations, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), run ...


10.21.15

Directory Assistance: Maintaining Reliable Provider Directories for Health Plan Shoppers

Since implementation of the ACA, more consumers are shopping for health insurance through the individual commercial market. Many of these consumers are obtaining insurance for the first time and must navigate a complex coverage market and make important decisions for themselves and for their ...


06.22.15

Examining Fee Splitting Statutes in the Context of Value-Based Healthcare

Fee splitting prohibitions are aimed primarily at situations where a healthcare professional, in order to generate patient referrals from other licensed or unlicensed persons, splits part of the professional fee earned from treating the referred patient with the source of the referral.