A year in review: top blogs from 2019

The new year is upon us and with it comes a new decade. It has been a decade of transformation for healthcare with regulatory changes, health system consolidation, healthcare consumerism, and new technologies that have forever changed the industry. 2019 has been a time of change and growth for Discovery Health Partners as well. Here are highlights from our most popular blogs of 2019 to remind you what we’ve been up to all year.

3 bad habits that are good for subrogation

In February, we talked about the three “bad habits” that can lead to successful subrogation: be unfair, ignore your members, and be pushy. In any other scenario, these tactics can get you into trouble. But for subrogation, being unfair requires that you not treat all cases equally. Ignoring your members is all about avoiding member abrasion. And being pushy involves aggressively identifying and verifying subrogation cases. Altogether, these tactics help improve the opportunity for quick and fair settlement of subrogation cases.

Why Medicare Advantage plans may be losing money on members with ESRD

In March, we featured a post about the challenges Medicare Advantage plans face with members with end-stage renal disease (ESRD). Though ESRD afflicts fewer than 100,000 people nationwide, the disease requires lifelong care—and a disproportionate percentage of medical expense. The blog discusses the gap in CMS premiums for ESRD members and what Medicare Advantage plans can do to better identify them.

It’s challenging to identify and restore underpaid ESRD premiums. Here’s how to solve that

Another popular blog continued the ESRD discussion, highlighting a systematic approach Medicare Advantage plans can take to restore ESRD premiums. This includes automating the process of sifting through data to identify potentially underpaid premiums and maximizing the 84 months that CMS allows plans to identify, investigate, and restore premiums. The blog identifies five key components of an effective ESRD program: analytics, investigation, remediation, restoration, and monitoring.

Subrogation: 3 ways SaaS can help

In July, we returned to the topic of subrogation with a discussion of how software-as-a-service applications can help. Plans are finding that combining SaaS applications with in-house expertise creates a more effective, data-driven approach for finding and validating subrogation recovery opportunities. Specifically, you can: 1) make in-house recovery more efficient and insightful; 2) gain accessible, easy-to-use, scalable, and secure solutions; and 3) do more at a lower cost.

Stay tuned to our blog for more insights on these topics and to see what 2020 has in store. You can also get the latest industry and Discovery updates by following us on LinkedIn and Twitter. Are you interested in learning how Discovery Health Partners can support your organization? Contact us today!

Discovery Health PartnersA year in review: top blogs from 2019
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Discovery Health Partners’ case open logic machine learning initiative receives FutureEdge 50 award from IDG

Itasca, IL – December 16, 2019 – Discovery Health Partners has been named an honoree of a 2020 FutureEdge 50 award from IDG’s CIO. This prestigious honor is given to organizations that are pushing the edge with new technologies to advance their business for the future. Discovery will accept its award at the AGENDA20 Conference held March 23 – 25 at the Sawgrass Marriott Golf Resort & Spa in Ponte Vedra Beach, Florida.

Discovery’s case open logic initiative was piloted earlier this year to test machine learning as part of its claims ranking process within its Subrogation practice. Already a leader in analytics-powered technology solutions for some of the top health payers in the country, Discovery saw an opportunity to leverage its decade of case outcomes data to fuel a subrogation model that eliminates hours of manual work, results in more accurate case identification, and reduces member friction. Discovery is implementing improvements and enhancements and intends to roll out similar machine learning capabilities to other lines of business such as Data Mining, Clinical Audit and Coordination of Benefits (COB).

“Discovery’s data science team has been blazing new trails in the payment integrity industry through advanced analytics and machine learning capabilities,” stated Discovery CIO Dan Iantorno. “Combining technology innovation with our team’s decades of experience in the health payer space is at the heart of how we deliver game-changing results for our customers.”

“The organizations in the FutureEdge 50 are doing exciting things that would have been unimaginable just a few years ago. For example, there’s a project using blockchain and quantum computing to establish trust; an indoor navigation system; and many uses of AI/ML for insights and efficiency,” said Anne McCrory, group vice president, customer experience and operations, events, and the FutureEdge and AGENDA20 conference chair. “We are honored to showcase these innovations and many others as we enter into a new era of sophistication with cloud, devices, and environments powering the technology-driven business.”

For more information about how Discovery Health Partners’ award-winning team and technologies are helping health payers solve payment integrity challenges to improve financial and member outcomes, visit www.DiscoveryHealthPartners.com.

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 six years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

About the FutureEdge 50 Awards

The FutureEdge 50 awards recognize organizations pushing the edge with new technologies to advance their business for the future. The successor to the Digital Edge 50 awards, the FutureEdge 50 will recognize not only established initiatives driving business success but also early-stage projects pursued for their watershed potential. These initiatives may be in R&D, proof of concept or pilot phases. With this, the FutureEdge 50 awards aim to bring the most cutting-edge trials and applications of emerging technologies – and the innovative cultures enabling them — to our audience at the AGENDA conference.

About CIO

CIO focuses on attracting the highest concentration of enterprise CIOs and business technology executives with unparalleled expertise on business strategy, innovation, and leadership. As organizations grow with digital transformation, CIO provides its readers with invaluable peer insights on the evolving CIO role as well as how leading IT organizations are employing technologies, including automation, AI & machine learning, data analytics and cloud, to create business value.

The award-winning CIO portfolio — CIO.com, CIO events, CIO Strategic Marketing Services, CIO Forum on LinkedIn, CIO Executive Council and CIO primary research — provides business technology leaders with analysis and insight on information technology trends and a keen understanding of IT’s role in achieving business goals. CIO is published by IDG Communications, Inc. Company information is available at www.idg.com.

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Discovery Health PartnersDiscovery Health Partners’ case open logic machine learning initiative receives FutureEdge 50 award from IDG
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eBook: The modern guide to COB

eBook: The modern guide to COB

Manual and error-prone Coordination of Benefits processes contribute to millions of dollars in annual waste

Save time, resources, and paper with advanced technologies that can help you transition from cost recovery to cost avoidance.

Download our eBook and see how a modern COB approach can help you:

  • Increase recoveries
  • Improve cost avoidance
  • Reduce administrative costs
  • Achieve greater member and provider satisfaction

Discovery Health PartnerseBook: The modern guide to COB
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Discovery will co-present with Humana at the NASP 2019 Annual Conference

Discovery Health Partners will co-present with Humana at the NASP 2019 Annual Conference

Date:  October 27-30, 2019

Location: Gaylord National Resort & Convention Center, Washington, DC

The NASP 2019 Annual Conference features over 60 educational sessions among 9 subrogation tracks: auto, general, health, management, product liability, property, specialty, fundamentals, and workers’ compensation.

On Tuesday, October 29, at 2:00pm, Heather Rodemann, Discovery VP of Subrogation Operations, will present alongside Nicole Hepburn, Humana Subrogation and Other Third-Party Liability. The session, titled “How to Acquire and Keep Top Subrogation Talent,” will help attendees identify the soft and hard skills needed to ensure success for subrogation professionals across the spectrum of roles—from call-center employees to leaders—including potential interview questions and skill assessments. During this session, attendees will learn the keys to an onboarding training program that ensures that new hires are set up for success; find out how to drive employee engagement and job satisfaction, including employee recognition and performance incentive programs; and learn more about career pathing that increases employee retention and allows them to move up and laterally within the subrogation department.

Visit the NASP 2019 Annual Conference page to register.

Discovery Health PartnersDiscovery will co-present with Humana at the NASP 2019 Annual Conference
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Is your company ready to grow through acquisition?

In his latest Chief Executive article, Discovery CEO Jason Brown shares his experiences and lessons from Discovery’s first acquisition. Jason walks through the entire process, offering insight into preparation, integration, and ensuring continued success after completion.

Click here to read the full article.

Discovery Health PartnersIs your company ready to grow through acquisition?
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2019 NHCAA Annual Training Conference

Discovery Health Partners is a proud sponsor of the NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference (ATC)

Date:  October 15-18, 2019

Location: Nashville Music City Center, Nashville, Tennessee

The NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference (ATC) is recognized as the single-most important healthcare anti-fraud event, spotlighting trends and emerging schemes.

This event brings together industry leaders from the private and public sectors to share information on best practices to detect, investigate, prosecute and prevent fraud, waste and abuse.

Visit the Discovery Health Partners team in Booth #312 at this year’s ATC to learn more about how a connected payment integrity approach can help you:

  • Dig deeper into your data with a pre- and post-payment Data Mining solution
  • Find and validate more members with other health insurance
  • Maximize recoveries from other responsible parties
  • Detect and deter billing errors
  • Reduce waste and drive revenue growth

 

Visit the NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference page to register.

Discovery Health Partners2019 NHCAA Annual Training Conference
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Case study: Coordination of Benefits (COB) for healthcare payers

Case study: Healthcare Coordination of Benefits (COB)

COB solution drives measurable cost savings and millions of dollars in recoveries for three health plans

As these three cases demonstrate, the Discovery Coordination of Benefits solution was designed specifically to address critical COB challenges, with an emphasis on flexible delivery models that support our clients’ unique requirements.

Harnessing the power of our Healthcare Analytics Platform, our COB solution enables fast and accurate identification, investigation, case management, dashboards, and analytics, as well as insourced or outsourced delivery.

Download this insightful case study today.

Discovery Health PartnersCase study: Coordination of Benefits (COB) for healthcare payers
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Cathy Eddy joins as newest member of Discovery Health Partners Strategic Advisory Board

Itasca, IL – September 17, 2019 – Discovery Health Partners today announced that Health Plan Alliance founder and former president, Cathy Eddy, has joined its Strategic Advisory Board. Discovery’s Strategic Advisory Board is charged with guiding the company 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.

“We are thrilled to welcome Cathy to our Strategic Advisory Board,” stated Discovery CEO Jason Brown. “Her passion and leadership in the health plan industry is renown, and we consider it a privilege to have her taking an active role with Discovery as we pursue aggressive growth and innovation goals while delivering the best possible payment integrity outcomes for our customers. There are few who know the needs of provider-sponsored plans—a key customer group for us—better than Cathy. Her insights will help us to continue to align our services to these health plans’ goals.”

Cathy founded the Health Plan Alliance in 1996 (formerly HMO Alliance), an organization that helps provider-sponsored and independent health plan members be more competitive in their individual markets by sharing a broad knowledge base, identifying performance improvement methods, enabling collective purchasing, and sharing insights. Under Cathy’s leadership, the Health Plan Alliance grew to 50 members. She retired as president in April 2018. In addition to her leadership at Health Plan Alliance, Cathy has extensive advisory and speaking experience with numerous boards and health organizations.

Formed in May of 2019, current Discovery Strategic Advisory Board members include: Amanda Fox, Healthcare and Insurance Practice Partner, Spencer Stuart (retired); Michael Cotton, CEO, Providence Health Plan; and Wheeler Coleman, CEO, EC-United, and former CTO at HCSC.

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 six 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 PartnersCathy Eddy joins as newest member of Discovery Health Partners Strategic Advisory Board
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Case study – How Discovery is increasing healthcare subrogation recoveries

Case study – How Discovery is increasing healthcare subrogation recoveries

Discovery Health Partners leverages people, process, data, and technology to improve subrogation results for healthcare payers.

Discovery Health PartnersCase study – How Discovery is increasing healthcare subrogation recoveries
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Discovery: Three Subrogation client success stories

Discovery: Three Subrogation client success stories

This case study shows how Discovery generated millions in subrogation recoveries with Discovery’s analytic-driven, member-sensitive approach.

For more information

Please visit our Subrogation page or open the contact tab on the right to get in touch with a Business Development Associate.

Discovery Health PartnersDiscovery: Three Subrogation client success stories
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