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Session 130: Fraud Detection in Health Care, With and Without Predictive Analytics
Session 130: Fraud Detection in Health Care, With and Without Predictive Analytics The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an ...- Authors: Kwame Smart, Mark Russell, Steve Richardson
- Date: Feb 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Health & Disability>Health insurance; Health & Disability>Payment models
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Session 186: Evolving Value Based Programs and the Impacts on Provider Analytics & Reporting
Session 186: Evolving Value Based Programs and the Impacts on Provider Analytics & Reporting As value-based solutions evolve, it is more important than ever for providers to understand their ...- Authors: Patrick Jason Colbert, Jeremiah Reuter, Joshua McPhee
- Date: Mar 2020
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability; Health & Disability>Payment models
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Session 095: Drug Claim Management - Lessons from Canada
Session 095: Drug Claim Management - Lessons from Canada The presenters will focus on best practices in drug claim management in North America. The presentation is geared toward Canadian practice ...- Authors: Daniel Berty, Martin Chung, Erin Crump, Ned Pojskic
- Date: Feb 2020
- Competency: Results-Oriented Solutions
- Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Payment models
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Direct Contracting and Other Models: How CMS, Providers, and Employers Continue to Challenge the Status Quo
Direct Contracting and Other Models: How CMS, Providers, and Employers Continue to Challenge the Status Quo This session will explore the various contracting techniques that CMS, providers, and ...- Authors: Matthew Smith, James Gerald Lucas, Brian Allen Sweatman
- Date: Jun 2020
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability; Health & Disability>Payment models
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Session 169: Risk Adjustment in Medicaid: Recent Developments
Session 169: Risk Adjustment in Medicaid: Recent Developments The presenters will cover the variation in risk adjustment approaches used across state Medicaid programs and compare them to other ...- Authors: Edward M Mailander, Daniel Henry
- Date: Feb 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Health & Disability>Payment models; Public Policy; Public Policy