Discovery Health Partners names vice president of payment optimization

ITASCA, IL (June 5, 2019) — Discovery Health Partners today announced that Subrahmanyam Mantha has joined the Discovery leadership team as Vice President, Payment Optimization. In this new role, Mantha will tap into his more than 20 years of managed healthcare and payment integrity experience to help Discovery’s clients better control costs associated with incorrect billing and overpaid claims and to improve health plans’ administrative and medical loss ratios.

“Expanding our payment integrity offerings is an important part of our growth strategy, and Mantha will play a key leadership role in making that happen,” stated Discovery CEO Jason Brown. “With this new payment optimization executive role and our recent acquisition of HealthMind, Discovery is demonstrating that we are fully committed to delivering the best pre- and post-payment optimization results for our customers.”

“Discovery has a stellar reputation for being a leader in subrogation, COB, and premium restoration, and I’ve seen how they’ve aggressively been expanding their payment integrity footprint,” stated Mantha. “I am thrilled to be a part of growing this strategic business line and to be a part of a company with such a promising future.”

Before assuming the leadership role for payment optimization at Discovery, Mantha spent more than 20 years in a variety of operations and leadership roles supporting managed care organizations and building payment integrity programs. Most recently, Mantha led the development and deployment of prepay analytics solutions for a large global payment integrity company, supporting several top-10 health plans. Prior to that, Mantha was Senior Vice President at SCIO Health Analytics, where he delivered analytics solutions to support Payment Integrity operations, healthcare analytics, and global delivery operations.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 70 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners names vice president of payment optimization
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Discovery Health Partners forms Strategic Advisory Board

New board advances Discovery’s position as a leader in payment integrity for U.S. health payers

Itasca, IL – May 21, 2019 – Discovery Health Partners today announced the formation of a Strategic Advisory Board comprised of industry veterans and forward thinkers in the healthcare payer technology space. This board will guide Discovery in advancing its industry-leading solutions portfolio to help health plans proactively avoid costs, improve the accuracy of claims payments, and protect the erosion of premium revenue through emerging technologies, services, and best practices.

“Discovery’s Strategic Advisory Board is an integral part of achieving the aggressive goals we have laid out for the years ahead,” stated Jason Brown, CEO of Discovery Health Partners. “With their collective industry knowledge, our advisors will help us connect more deeply to solve healthcare executives’ top priorities. This will give us a huge advantage as we expand and sell more complex solutions into a competitive marketplace.”

Inaugural board members include:

AMANDA FOX
Healthcare and Insurance Practice Partner, Spencer Stuart (retired)

Before her professional retirement, Amanda Fox was a partner with Spencer Stuart’s global Healthcare and Insurance practices and led the firm’s insurance industry search efforts. Amanda led a number of confidential CEO succession assignments for most of the top insurance companies and partnered with one of the largest national payers to restructure the senior leadership team following a CEO succession. She worked with regional and local health plans, specialty firms, and with new subsectors emerging as a result of U.S. healthcare reform. Amanda holds a B.A. in political science from Randolph-Macon Woman’s College (now Randolph College) and sits on the advisory committee of the Society of Actuaries.

MICHAEL COTTON
CEO, Providence Health Plan

Mike Cotton joined Providence Health Plan as chief executive officer in 2015. With more than 25 years’ experience in healthcare, Mike provides strategic leadership for Providence Health Plan’s commercial, self-funded, Medicare, and Medicaid programs. Prior, Mike was vice president and chief operating officer for Humana and held executive management roles with Evolent Health and Alere Health. In addition, Mike has led provider sponsored health plans affiliated with University Hospitals Health System and Premier Health System. Mike graduated from Cleveland State University, earning an MBA in healthcare administration, and holds a certificate of executive healthcare management from Case Western Reserve University.

WHEELER COLEMAN
CEO and Executive Partner, EC-United

Wheeler Coleman is CEO and Executive Partner at EC-United, a boutique IT consulting firm specializing in delivering innovative solutions that transform businesses. Prior to his CEO role, Wheeler was a two-time CIO and former CTO of the nation’s fourth-largest health insurance company where he spent 25-plus years on the management team. Throughout his career in the health payer industry, Wheeler has built a reputation for transforming business and simplifying IT to meet business needs, driving optimum bottom-line returns, reducing costs, minimizing inefficiencies, improving capabilities, building high-performance teams, and integrating emerging technology strategically for long-term growth. Wheeler is an MBA graduate of the University of Notre Dame.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 70 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners forms Strategic Advisory Board
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Discovery Health Partners expands pre-pay payment integrity solution portfolio with acquisition of HealthMind

Acquisition underscores Discovery’s strategy of delivering a comprehensive suite of payment and revenue integrity solutions powered by superior technology and advanced analytics  

Itasca, IL – May 16, 2019 – Discovery Health Partners, an industry leader dedicated to helping healthcare payers solve payment and revenue integrity challenges to improve financial outcomes, today announced they have acquired HealthMind, LLC.

The acquisition of HealthMind adds secondary code edit, provider audit, and data mining capabilities to Discovery’s leading portfolio of payment and revenue integrity solutions. And it brings ReThink, an integrated software platform that supports multiple payment accuracy programs on both a pre- and post-pay basis. Unlike most vendors’ siloed platforms, the ReThink platform enables editing, clinical auditing, and data mining solutions to talk and share data, increasing efficiencies, productivity, and results for health plans.

“We’re excited about combining our payment integrity solutions and advanced analytics with HealthMind’s robust technology platform. We now can offer a market-leading payment integrity suite of solutions that focuses on pre-pay cost avoidance, improves provider relations, and generates superior recoveries,” said Discovery Health Partners CEO Jason Brown. “Discovery has developed strong relationships with our clients based on the value we’ve delivered over the years, and we’re excited to produce even stronger results for our customers going forward with our newly expanded solution portfolio.”

“Discovery is the perfect home for our solutions and our customers,” said Gary Twigg, CEO of HealthMind. “Discovery’s reputation and solutions complement what the HealthMind team has built and will allow Discovery to exponentially expand services and financial outcomes for customers.”

“Through this acquisition, Discovery is adding capabilities and solution enhancements that underscore our customer commitment. This is an important milestone for Discovery that reinforces the strong leadership position we’ve established in the industry,” added Steve Unterberger, Carrick Capital Partners Managing Director and a member of the Discovery Board of Directors.

Comprehensive solutions for a growing industry problem

With U.S. healthcare spending projected to grow at least 5.8% annually and to represent 19.6% of GDP by 20241, taking waste and improper payments out of the system is a growing issue as well. Back in 2009, the Institute of Medicine estimated that waste consumed 30 percent of U.S. health dollars. Two years later, the midpoint of waste was placed much higher, at 34 percent. Factoring in the steady rise in overall health expenditures implies that wasted healthcare spending now exceeds $1 trillion annually2.

To combat these rising expenses, it is imperative that health plans find ways to decrease their exposure to claims that are paid incorrectly or shouldn’t be paid at all. Discovery’s newly expanded suite of payment and revenue integrity solutions has been designed to reduce health plans’ exposure and increase payment accuracy by analyzing claims before and after they’re paid.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 70 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

1      The Office of the Actuary in the Centers for Medicare & Medicaid Services. (July, 2015). National Health Expenditure Projections 2014-2024, The Office of the Actuary Annual Projections of Health Care Spending. Retrieved from: http://www.cms.gov.

2      https://www.healthaffairs.org/do/10.1377/hblog20180530.245587/full/

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Discovery Health PartnersDiscovery Health Partners expands pre-pay payment integrity solution portfolio with acquisition of HealthMind
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Discovery Health Partners appoints health payer technology veteran to CIO role

ITASCA, IL (May 7, 2019) — Today, Discovery Health Partners welcomed Dan Iantorno to its leadership team as Chief Information Officer. Iantorno brings an extensive background in building robust, reliable, and scalable solutions in high-growth environments.

“Dan’s unique blend of health payer, technology, and business expertise will serve us well as we continue to aggressively pursue our strategy of developing new solutions and integrating complementary solutions into our portfolio through acquisitions,” stated Jason Brown, Discovery CEO.

“I’m very excited to bring my business-driven IT approach to Discovery,” said Iantorno.  “This is a great time to be at Discovery and help architect a new level of technology solutions that will meet more needs and deliver even more value for our clients.”

Prior to joining the team, Iantorno spent over two decades in technology innovation, executive leadership, and private equity transaction advisement in healthcare and other industries. He was formerly Chief Information Officer at The Allant Group and Valence Health (now Evolent Health), where he modernized payer and provider applications and infrastructure platforms and transformed IT operations to support the needs of those rapidly growing enterprises.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 70 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners appoints health payer technology veteran to CIO role
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Discovery Health Partners tackles subrogation transformation initiative, achieves 20% more recoveries for clients

ITASCA, IL (April 30, 2019) – Discovery Health Partners today announced a 20 percent growth in subrogation recoveries for its clients from 2016-2018 and is looking to more than double those results in 2019. This increase is due to Discovery’s strategic four-pronged subrogation transformation initiative spanning its people, process, data, and technology components.

People: Discovery has made significant investments in key subro leadership positions, including the appointment of a new Vice President of Subrogation Operations, Heather Rodemann. It has increased it paralegal staff by 10% and has moved to a remote, national workforce in order to have access to superior talent. In addition, the company expanded its training program to include enhanced negotiation tactics.

Process: Procedural enhancements include a leadership role dedicated to efficiency and automation; stronger alignment of resources with cases based on skills and case complexity; and standardization of KPIs to improve consistency, best practices, and efficiency. The company’s quality audit program boasts scores of 99 percent for financial audits and 97 percent for procedural audits.

Data: Discovery has increased the variety and number of data sources it accesses with its proprietary machine learning and predictive analytics processes, including claims, eligibility, and provider data, as well as external third-party data providers. These enhancements help to identify and validate subrogation claims faster and more accurately. A multi-variant approach to diagnosis codes helps identify cases that otherwise might be missed.

Technology: Discovery has also fine-tuned its technology platform, including a HITRUST CSF® certified file transfer system and improvements to Discovery Case Manager, which guides the case investigation and recovery process, maintains a record of all activity and correspondence, and provides 24×7 visibility into subrogation case inventory and progress.

“Being able to identify and validate recoveries faster, with more accuracy, and with less member outreach further solidifies Discovery’s Subrogation solution as a best-in-class model for the industry,” stated Heather Rodemann, Vice President of Subrogation Operations. “It has been incredibly rewarding to see our team’s hard work and planning result in growth at Discovery and in more significant and accurate recoveries for our clients.”
Discovery is also making improvements to key areas of its Subrogation solution including enhanced pre-payment capabilities. Click here for additional information on Discovery and its Subrogation capabilities.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 60 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners tackles subrogation transformation initiative, achieves 20% more recoveries for clients
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The Importance Of Delivering Profound Client Value

Today’s Chief Executive feature article spotlights Discovery CEO Jason Brown‘s insights on creating a corporate culture that delivers profound client value. Jason talks about what his early work experience taught him about always staying focused on the customer and shares insights on how other CEOs can build a customer-centric culture.

Click here to read the full article.

Discovery Health PartnersThe Importance Of Delivering Profound Client Value
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Discovery Health Partners to showcase expertise in advanced technologies and best practices for maximizing revenue and recoveries at 2019 NOPLG Conference

ITASCA, IL (April 1, 2019) – Discovery Health Partners is a Silver Sponsor of the 2019 NOPLG Conference for Blue Cross and Blue Shield plans. Discovery’s team of seasoned payment integrity experts (Booth #20) are available to discuss advancements in technologies, solutions, and best practices for subrogation and COB cost avoidance and recovery, as well as Medicare Secondary Payer (MSP) and end-stage renal disease (ESRD) premium restoration.

“Technologies that help plans proactively avoid costs, improve the accuracy of claims payments, and protect the erosion of premium revenue are advancing so quickly. It has become a serious challenge for health plan leaders to know just where to turn for the right solution for their needs,” stated Heather Rodemann, Vice President of Subrogation Operations for Discovery. “Our team is dedicated to being an innovative solutions partner for our Blues clients.”

Discovery recently announced it has signed up more than 20 plans for its new ESRD Premium Restoration solution and has helped these clients identify and restore millions in underpaid premiums.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 60 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners to showcase expertise in advanced technologies and best practices for maximizing revenue and recoveries at 2019 NOPLG Conference
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Discovery Health Partners Leads “Optimizing Revenue Beyond Risk” roundtable at 2019 RISE Summit

ITASCA, IL (March 18, 2019) — Discovery Health Partners is pleased to be a silver sponsor and roundtable presenter at the 2019 RISE Summit in Nashville. In addition to exhibiting (Booth #26), Discovery will lead the “Optimizing Revenue Beyond Risk” roundtable discussion tomorrow morning from 8:00 – 9:00 a.m. in the main exhibit hall at the Gaylord Opryland Resort.

Lyndsay Deckert, Discovery’s Director of Solution Management, Analytics & Strategy, will share insights in revenue optimization through:

“Underpaid premiums cost plans millions of dollars in lost revenue each year,” said Deckert. “We’re happy to share ideas with health plans at this year’s RISE around advanced technologies and best practices for maximizing recoveries.”

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 60 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners Leads “Optimizing Revenue Beyond Risk” roundtable at 2019 RISE Summit
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2019 NOPLG conference

Discovery Health Partners is a silver sponsor for 2019 NOPLG

Date:  March 31-April 3, 2019

Location: Hyatt Regency Savannah, Georgia

The National Other Party Liability Group (NOPLG) is an organization of professionals who manage Other Party Liability (OPL) activities in Blue Cross Blue Shield (BCBS) Plans across the nation. This annual educational seminar is open to BCBS employees, BCBS subsidiary employees and BCBS OPL contractors.

NOPLG brings together participants for workshops, networking, and discussion of issues involving Coordination of Benefits (COB), Subrogation, Workers’ Compensation (WC), Medicare Secondary Payer (MSP), OPL Management and Over-payment Identification and Recovery.

Visit the 2019 NOPLG conference website for additional conference information.

Discovery Health Partners2019 NOPLG conference
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Discovery Health Partners signs up more than 20 health plans for its new ESRD Premium Restoration solution

ITASCA, IL (March 12, 2019) – Discovery Health Partners today announce that since the launch of its ESRD Premium Restoration solution in late 2018, more than 20 health plans ranging from large national to small regional plans have signed on for the new solution. To date, Discovery Health Partners has helped identify and restore millions in underpaid premiums for these customers.

Discovery’s ESRD Premium Restoration solution helps Medicare Advantage (MA) plans restore underpaid premiums from Centers for Medicare and Medicaid Services (CMS) for members with ESRD. ESRD, end-stage renal disease, is the final stage of chronic kidney disease and requires patients to undergo dialysis or a kidney transplant to survive. These treatments are expensive and require life-long care. CMS pays MA plans a significantly higher premium for each member with ESRD to help cover the higher costs of treatment. But for various reasons, CMS sometimes does not accurately identify members with ESRD. When this happens, MA plans don’t receive the higher premiums from CMS and, therefore, operate at a deficit for these members.

“MA plans are challenged with efficiently managing members with ESRD, navigating CMS processes, and working with service providers to optimize financial outcomes,” said Kevin McDonald, Vice President of Eligibility Operations at Discovery Health Partners. “Discovery is adept at navigating these complex processes, and this expertise fills a real need for clients. We are pleased to support large and small health plans through this complex process of restoring underpaid premiums and ensuring accurate premiums are received going forward.”

Discovery Health Partners’ ESRD Premium Restoration solution adds to its suite of solutions that help health payers improve revenue, avoid costs, and enhance the member experience.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 60 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Learn more about our ESRD solution.

Discovery Health PartnersDiscovery Health Partners signs up more than 20 health plans for its new ESRD Premium Restoration solution
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