Healthcare Finance Research & Insights
Cost and Compensation: A Values Based Approach
Creating a collaborative and results focused economic environment requires a values based approach to cost and compensation for physicians and payers.
Read MoreUnderstanding the Overpayment Recovery Process
Understanding the overpayment recovery process helps health plans balance the financial fitness of a health plan with effective delivery of healthcare.
Read MoreHospital Readmission Reduction Program Audit
Understand the ins and outs of a hospital readmission reduction program audit and the complexities around DRG readmission policies from the FRG experts.
Read MoreData Mining for Multiple Diagnostic Radiology Overpayments
A recent audit of National Medicare Health plan, found over $400,000 in overpayments in a 12-month period for multiple diagnostic radiology claims.
Read MoreMedical Risk Adjustment in Global Capitation Arrangements
Gain the framework needed for understanding medical risk adjustment and the business processes required to perform under a global capitation arrangement.
Read MoreThe Benefits of a Medical Claims Audit
There are numerous approaches and benefits of a medical claims audit. Understand the types of medical claims audits and how they help everyone involved.
Read MoreWhat is Population Health?
What is Population Health? It really explores the underlying social & cultural issues that affect the health of large populations and their health outcomes.
Read MoreReinsurance and Stop Loss in Provider Incentive Plans
Get the facts about reinsurance and stop loss in provider incentive plans. Review the types of agreements and benefits of stop loss programs.
Read MoreUnderstanding Medical Reinsurance
Medical reinsurance, also known as stop loss insurance is an added layer of protection that help cover situations that are outside even the best predictive models. Understand more about medical reinsurance now.
Read More10 Facts about HEDIS Reporting & Measurements
HEDIS measures are revised every year and are strictly defined and are the reporting guidelines for gaps in care. Take a look at the 10 facts about HEDIS reporting our expert team has compiled.
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