by Di Simplot | Mar, 2025 | news, Thought Leadership
Fraud in healthcare billing and payment continues to be a serious risk for payers and providers alike. Billions of dollars are misappropriated every year resulting in increasing costs throughout the healthcare delivery system.Public and private payers are serious...
by Di Simplot | Feb, 2025 | news, Thought Leadership
Headwinds and Strategies to Weather the StormThe Medicare Advantage market appears to be at a critical crossroads. The past few years have seen unprecedented enrollment growth, fueled by a rapidly increasing over 65 population and a favorable regulatory environment....
by Di Simplot | Feb, 2025 | news, Thought Leadership
Leveraging Social Determinants of Health Social determinants of health (SDOH) refer to the non-medical factors that influence health outcomes. These factors are shaped by the environments in which people live, grow, work, play, and age, as well as the broader societal...
by Di Simplot | Jan, 2025 | news, Thought Leadership
Data, Applications, Benefits and Challenges: Much of the success in reducing morbidity and mortality over the past half century has been due to earlier detection of disease, in tandem with public health measures such as smoking cessation and weight management; as well...
by Di Simplot | Dec, 2024 | news
Value-Based Care (VBC) is a healthcare model that ties healthcare providers’ compensation to the quality, equity, and cost of care they deliver. The model focuses on improving patient outcomes, such as health quality and satisfaction, while also promoting...
by Di Simplot | Nov, 2024 | news
CMS Interoperability and Prior Authorization Final Rule SynopsisThe Centers for Medicare & Medicaid Services (CMS) changed its prior authorization rules to simplify and digitize the process, and to reduce the burden on each of the three legs in the healthcare...
