The National Committee for Quality Assurance (NCQA) is accepting comments through March 11 on proposed changes for HEDIS® Measurement Year 2022 (MY 2022), which will be published in August 2021. Jamison Gillitzer, product director for Cotiviti’s quality improvement solutions, summarizes the important details on proposed… Read More »NCQA publishes proposed changes to HEDIS measures for MY 2022
To build a successful quality improvement program, health plans not only must stay ahead of annual changes to HEDIS® reporting requirements, but also a continually expanding list of state and other custom measures to track as well. Amid all this change, Cotiviti’s Quality Intelligence solution… Read More »Cotiviti achieves 20 years of HEDIS® certification amid expanding quality landscape
It’s clear that rewarding providers for value, not volume, of services reduces unnecessary and costly care, but transitioning from the traditional fee-for-service model is challenging. Providers respond best to a transparent, data-driven approach in which “value” is clearly and objectively defined. But how can health… Read More »Webinar: Improving value-based care through data-driven insights—lessons from Florida Blue Medicare
As many health plans know, achieving a higher Star Rating will soon be more challenging. The Centers for Medicare & Medicaid Services (CMS) is changing the makeup of the rating system, with two changes to patient experience weighting set to take place in 2021 and… Read More »CMS Star Ratings: Navigating changes in 2021 and the coming years
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Understanding how individuals vary on disease susceptibility is becoming increasingly important for clinicians to deliver effective treatment to their patients. For example, some patients are fortunate to survive cancer multiple times, while others die within a few months of their diagnosis. This variation can be… Read More »Precision medicine’s value to complex disease management
With Medicare open enrollment set to begin this week, the Centers for Medicare & Medicaid Services (CMS) has released the 2021 Star Ratings for Medicare Advantage plans with prescription drug coverage (MA-PD) as well as standalone MA and PD plans, based on data from calendar… Read More »Cotiviti clients outperform the field in 2021 Star Ratings
Cotiviti’s Signature Series features interviews with senior health plan leaders on how to improve clinical and financial outcomes in healthcare. To address rising healthcare costs and nurture care that drives positive patient outcomes, healthcare stakeholders are looking for ways to reward providers for value, not… Read More »Q&A: How Arkansas Blue Cross created a value-based payment model
When health plans embarked on this year’s HEDIS® season (Measurement Year 2019) in January, it is unlikely any of them realized just how drastically the U.S. healthcare system would change within the following six months, leading to exceptional challenges for both payers and providers. Now… Read More »
For too many Americans, healthcare is becoming increasingly unaffordable as medical inflation outpaces increases in wage earnings. To address this challenge, many health plans are looking to move from fee-for-service payment to a value-based compensation model that discourages inefficient use of healthcare resources and rewards… Read More »Webinar: A data-driven approach to value-based payment
While many employers are focused on helping their employees cope with the COVID-19 pandemic, the need to manage opioid abuse and addiction continues to remain strong. At the Pharmacy Quality Alliance (PQA) 2020 Annual Meeting held this month, Cotiviti’s Jamie Jenkins, senior program manager, and… Read More »How employers can use claims data to address opioid addiction