Discovery Health Partners does it again, making the Inc. 5000 list for the seventh year in a row

ITASCA, IL (August 12, 2020) – Discovery Health Partners today announced that the company has been named to the annual Inc. 5000 list for the seventh year in a row. Discovery’s three-year revenue growth was enough to bump the company’s ranking to position number 4008 on this prestigious list of the nation’s fastest-growing private businesses.

According to Inc., only a very small fraction of the companies that apply for the list makes the list more than once, and only 1.26 percent of those companies have made the list seven times.

“Making the Inc. 5000 list for seven consecutive years really puts Discovery in rare air,” said Discovery Health Partners CEO Jason Brown. “This is a direct result of the investments we’ve made in new solutions and analytics and a true testament to the incredible work our employees do every day to deliver profound client value. I’m very proud of our team and so happy to have their hard work recognized.”

“We’re very pleased with Discovery’s sustained, positive trajectory and the company’s ability to stay focused on client-centric growth and results. Earning the Inc. 5000 award for a seventh time puts an exclamation point on the fine work the Discovery team is doing,” commented Steve Unterberger, Carrick Capital Partners Managing Director and a member of the Discovery Board of Directors.

Complete results of the 2020 Inc. 5000 can be found here.

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. Serving more than 80 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth and innovation—earning a spot on the Inc. 5000 list seven years in a row, the Crain’s Fast 50 three times, and a prestigious FutureEdge 50 Award from IDG for innovations in machine learning. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners does it again, making the Inc. 5000 list for the seventh year in a row
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Your COB questions answered

As we meet with health plans of all shapes and sizes across the country, we’re frequently asked for advice regarding the Coordination of Benefits process, vendor selection, and orchestration with internal COB teams. Here, we share several of the common questions and our responses. 

Why consider Discovery Health Partners’ COB solution?

Your health plan’s success is based on the speed and accuracy of claims payments. Up to 15 percent of all members have other health insurance in any given year, costing plans millions in higher payments and administrative costs.

The Discovery COB solution is designed to go beyond other COB vendors by identifying more members with additional coverage—leading to less provider and member abrasion, additional claims recoveries, and avoided future expenses. Leveraging the power of technologies like Artificial Intelligence (AI) and predictive modeling, Discovery effectively integrates both traditional and non-traditional data sources to identify and determine the most successful indicators or combination of indicators of other coverage. We then use this information to automatically update analytic models to reflect that learning.

Does our organization need to change our existing COB processes?

No, your organization does not need to change its existing COB processes. Our COB solution is designed to work in concert with your existing internal and/or external vendor processes by harnessing the power of data mining and analytics to identify additional opportunities for recovery. To minimize duplication of efforts, our highly experienced staff works in partnership with your in-house COB, Operations, and IT teams. This enables your organization to retain current staff and gain additional savings. Our solution provides health plans with a “safety net” that delivers considerable incremental recovery opportunities with minimal disruption to operations.

How is Discovery’s COB solution different from internal operations or external vendors?

We built Discovery on both our staff’s deep subject matter expertise and the experiences learned while delivering successful payment integrity programs. Unlike traditional vendors that heavily rely on direct outreach, Discovery’s COB solution combines advanced technologies and extensive healthcare expertise to look at member eligibility more holistically, resulting in an increased number of high-value opportunities often missed by traditional means.

What does Discovery’s COB process look like?

Discovery takes a very flexible approach to its COB solution to accommodate different clients’ needs. Some of the options we offer with our COB solution include: mirroring a client’s internal COB team approach, acting as a turnkey vendor for COB efforts, focusing our COB efforts on all lines or business, and performing COB for only certain LOBs and/or claim types.

Does line of business matter?

No, line of business—whether commercial, Medicare, or Medicaid—does not matter. Discovery’s extensive knowledge of the various rules and regulations for each line of business allows us to perform COB services for all your covered lives. Discovery’s propriety algorithms and mining efforts are customized to deliver the most value possible across all your lines of business.

What should our organization look for when evaluating COB vendors?

The payment integrity market includes a wide range of COB vendors who offer to maximize recoveries and prevent future costs. When evaluating vendors, here are some things to think about:

Data: Where is the potential vendor getting its data and is the data relevant to your plan?

Expertise: What type of clients does the COB vendor work with today? Are they specialized in one line of business or do they work across multiple? Does the vendor have folks with plan-side experience?

Satisfaction: Does the vendor have a track record of delivering value to its clients?

Flexibility: Is the vendor flexible enough to wrap around your current team?

Technology: Is the vendor using technology like AI and machine learning to look at eligibility more holistically?

Research and development: Is the vendor relying on standardized practices that “worked before”? Or do they have a team of seasoned research analysts dedicated to looking for new rules, regulations, data sources, and data points to deliver additional value?

Full-service capabilities: Does the vendor offer solutions spanning all phases of the claims lifecycle (e.g., prospective, retrospective, hospice, etc.)?

Security: Is the vendor HIPAA and HITRUST compliant? What security standards and access policies are in place?

Partnership: Is the vendor willing to learn about your organization, what’s important you, and how to support your COB process and goals? Is this a joint collaboration and journey? Where does your plan line up with the vendor’s other clients? Will you be a priority for them?

 

Discovery is more than just another vendor—we are your partner, looking out for you every step of the way with proactive insight and information. Is this what you’re getting today? Learn more about our Coordination of Benefits solution.

Discovery Health PartnersYour COB questions answered
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Award-winning Discovery employee proves that small acts of accountability make a big impact

When a company sets hefty goals to deliver profound client value and create highly engaged employees, it’s not enough to communicate those goals to everyone. To be transformational, every single employee must be 100% committed to contributing to the company’s goals. 

Discovery has invested in a comprehensive accountability model based on the concept that when people take personal ownership of the company’s goals and accept responsibility for their own performance, they work at a higher level to ensure their own success AND the company’s overall success. 

Working with the culture management firm Partners in Leadership, Discovery has built a culture of accountability by sponsoring training workshops and holding weekly small-group huddles that let employees work on the four best practices of accountability—recognizing when there are gaps in execution, fully and personally owning responsibilities and aligning them to the company’s key results, creatively and collaboratively working on solutions, and actively executing on the solution while building an environment of trust.

“As I like to say, accountability is every Discovery employee’s best friend,” says Phil Garrison, VP of Human Resources at Discovery and the executive sponsor of the company’s accountability program. “For each of us at Discovery, the principles of accountability give us easy-to-use tools to improve our individual work performance, share honest feedback with each other, and contribute very directly to the company’s overall goals.  The concepts are so foundational, they can even benefit us in our personal relationships.”

Discovery has integrated the model into many aspects of the company’s processes, onboarding, and expectations, and accountability is a cornerstone of the company’s culture. The company’s new Accountability in Action award is one example.

Each quarter, this award recognizes Discovery employees who demonstrate they have a stake in the company and go above and beyond to contribute to the company’s key results by living the “what else can I do?” attitude.

The first-ever recipient of Discovery’s new Accountability in Action award is Beverly Orwig, an MSP Recovery Specialist who has been with Discovery less than a year. 

Beverly received the award—which includes a cash reward, an extra day off with pay, and other perks—for a small gesture done consistently at a challenging time for her team. When COVID-19 hit, Beverly recognized that the pandemic was causing a lot of stress for her coworkers and they were struggling to keep a positive mindset. She asked herself what else she could do to stand out, to make a difference. Beverly took it upon herself to start each morning by posting a positive message to motivate her team, help them push through the challenges, and hit their goals. Focusing on how the team was reacting to the new environment caused by COVID-19, Beverly knew that it can be very hard for people to stay engaged, stay aligned to company goals, and maintain a connection with the team. Beverly’s positive communication among the team members promoted the understanding that the team had the ability and would be able overcome obstacles.

Commenting on receiving the award, Beverly says, “I was beaming—winning made such an impact on me! It made me realize that one individual employee can make such a big difference in the company. This company empowers me every day. It’s what makes Discovery who we are—everyone pushing each other to continue the momentum, to move forward in the same direction.”

Beverly credits her supervisor Shawn Daniels with inspiring her and driving her motivation. “I never want to disappoint him,” Beverly explains. “When he sets a goal for me, well, I’m going to push to overachieve that goal. He takes a personal interest in me and my success and is consistently available to help me.”

Beverly feels she is succeeding at Discovery because of the tools and transparency that the company provides. “Discovery gives me all the tools I need and empowers me to do my job every day,” she says. If I don’t know something, there’s transparent management all the way up to the top to get questions answered. It doesn’t get better than that.” 

“I want to be here…I want to come here every day. How many people can say that? I love coming to work every day.”

When she’s not demonstrating accountability at work, Beverly is a murder-mystery bookworm; enjoys Blues, jazz, and swing music; and spends weekends baking and cooking great dishes.


Discovery has built a culture of accountability throughout the company and created a quarterly award to recognize employees that have a stake in the company and go above and beyond by living the “what else can I do?” attitude.

Congratulations to Q1 2020 Accountability in Action award runners-up!

Christine Garcia, Accountability in Action award runner-up
“Christine works to get the issues fixed rather than come up with temporary solutions. She is in constant contact and responds within minutes, often working late to make sure issues are resolved.”
Chad identified ways that Discovery’s platform could better support the business. He immediately took ownership and spearheaded the development of an app in record time—in addition to his day job.

If you’d like to learn more about the steps to accountability and building this kind of culture at your organization, we recommend the book The Oz Principle.

Discovery Health PartnersAward-winning Discovery employee proves that small acts of accountability make a big impact
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Webinar: COVID-19 roundtable | Helping you get payment integrity done

COVID-19 roundtable: Helping you get payment integrity done

What you can expect from this webinar

The COVID-19 pandemic has quickly and drastically changed the way we’re living and working these days. This webinar helps health plans solve payment integrity operational challenges associated with the COVID-19 pandemic.

  • Learn more about working from home, security infrastructure, and productivity
  • Gain insights from Discovery’s own experience transforming to a remote workforce company over a year ago

Use the quick form on the right to view the webinar on-demand.

Discovery Health PartnersWebinar: COVID-19 roundtable | Helping you get payment integrity done
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Enhancing premium restoration in four steps

Today, more than 22 million seniors and people with disabilities choose a Medicare Advantage plan, and enrollment is projected to increase to an all-time high of 24.4 million this year1. Do you have insight into how much revenue your plan might be losing in underpaid premiums?

Ensuring accurate premium payments for your Medicare Advantage members requires the right people, processes, and technology to identify your potential for premium restoration. It all starts with data. By integrating data sources and viewing eligibility data holistically, you can easily identify members with the greatest propensity for inaccuracy: those requiring Medicare Secondary Payer (MSP) validation and those diagnosed with end-stage renal disease (ESRD).

Here are four steps you can take to capture underpaid premiums:

#1: Identify members with premium restoration potential

The undisputed first step in capturing underpaid premiums is identifying those members with premium restoration potential. Our experience shows that an average of 4% of Medicare Advantage members have open MSP records, and 50% of those records have premium restoration potential. By identifying members with MSP or ESRD, your plan can ensure those members are accounted for in MMRs and in payments from CMS.

#2: Improve process efficiencies

When analyzing open MSP and ESRD occurrences, your plan needs to identify and prioritize those that require investigation. By allocating scarce resources to the activities that will have the greatest impact on the bottom line, you can ensure that dollars and staff time are spent wisely and efficiently.

#3: Monitor the financial impact

As premium restoration becomes more complex and when resources are limited, sophisticated monitoring is needed to achieve the results your plan expects. With a proactive approach to monitoring premium restorations, you will want to forecast how many dollars will be added to the premium check, uncover whether you have received every month of restored premiums, and maintain an audit trail to validate the outcomes and steps taken to correct inaccuracies.

#4: Maintain ongoing premium restoration activities

Given the impact it can have on your bottom line, the premium restoration process must be maintained on an ongoing basis. By ensuring payment accuracy throughout the year, you can capitalize on significant revenue opportunities month after month, year after year.

Discovery’s data analytics combined with our deep understanding of CMS eligibility rules can help your plan unlock the hidden value in your data and collect the full value of premiums owed.

Discovery Health PartnersEnhancing premium restoration in four steps
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eBook: Restoring millions for your Medicare Advantage plan

eBook: Restoring millions for your Medicare Advantage plan

Correctly paid Medicare Advantage premiums are a critical source of revenue for many health plans

Unlock the hidden value in your data to identify root causes of errors and collect the full value of premiums owed to your plan.

Download our eBook and find out how a Premium Restoration strategy can help you:

  • Identify members with premium restoration potential
  • Improve process efficiencies
  • Monitor the financial impact
  • Maintain ongoing premium restoration activities

Discovery Health PartnerseBook: Restoring millions for your Medicare Advantage plan
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How COVID-19 trends are impacting payment integrity

At the close of 2019, healthcare predictions echoed the challenges of years past: complex billing processes, changing regulations, and rising healthcare costs. It was no surprise that health plans would continue to tackle these long-standing issues that contribute to improper claims payments in 2020. Little did we know, though, that payers would find themselves facing these challenges in very unexpected ways amid a global pandemic.

Health plans, bracing for the full impact of COVID-19, will need to find ways to navigate the uncharted course―a course that is no longer focused primarily on cost efficiency, quality, and delivery standards. Rather, a new course is taking shape that centers on safety, performance, and demand.

Promoting safety and well-being

In response to the COVID-19 pandemic, most states have issued shelter-in-place orders, requiring non-essential businesses and staff to work from home. Health plans are now faced with either remaining open as a critical operation or moving operations to newly established remote environments. For some plans, the transition from offices to mandatory work-from-home settings can present initial challenges (e.g., operational requirements, data security). As these challenges are addressed, payers are also working with their provider partners to increase access to care while protecting providers and the community. For example, the expansion of remote care and monitoring services help support social distancing and reduce the risk of exposure to COVID-19.

Facing financial performance impacts

The total number of COVID-19 cases continues to rise, prompting healthcare associations to recommend the suspension of elective surgeries and procedures to maintain sufficient capacity to treat patients and minimize risks of exposure. As those types of claims decrease, we anticipate a spike of high-dollar inpatient claims to treat individuals affected by COVID-19. In fact, a recent analysis by S&P Global estimates a severe COVID-19 pandemic could cost U.S. health plans more than $90 billion in medical claims alone1. While several major health plans have recently pledged to waive costs associated with COVID-19 treatment, we can expect these costs will cause health plans to experience significant financial stress.

To offset these great costs, we recommend health plans with large Medicare populations to look to other areas to positively impact revenue. For example, Premium Restoration (the recovery and protection of premium revenue) is one way to maximize financial performance in 2020 while not disrupting COVID-19 initiatives.

Increasing demands on healthcare organizations

It’s no surprise that as COVID-19 cases continue to grow, so are claims for testing and treatment and, more importantly, high-dollar inpatient stays. To this end, the Centers for Medicare & Medicaid Services (CMS) has issued new guidelines that lift restrictions and offer more flexible coverage options (e.g., tele-health). The American Medical Association (AMA) has also provided special coding advice to help healthcare professionals during the COVID-19 public health emergency. And in an effort to help ease the strain the pandemic is creating for healthcare providers, health plans are suspending reviews on COVID-19 related claims

With so many rapidly changing policies and requests, the regulatory burden is mounting for both health plans and providers alike. It will be more important than ever to make sure your plan has the correct member eligibility to avoid months of catch-up. Given these uncertain times, we highly recommend plans have a strong coordination of benefits (COB) program in place to ensure accurate and updated eligibility data while driving future cost avoidance.

Contact Discovery Health Partners today to find out how we can help you with your payment integrity efforts amid COVID-19.

Access the latest COVID-19 information from our COVID-19 response page.

Discovery Health PartnersHow COVID-19 trends are impacting payment integrity
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Tips for staying connected amid COVID-19

As the COVID-19 outbreak continues, Discovery Health Partners employees are grateful to work remotely to help slow the spread of the disease. Discovery implemented remote and work-from-home capabilities over a year ago, which positions us extremely well to continue to support our clients’ business with minimal to no interruptions. In fact, we’ve already seen that our business model has helped us continue to be the partner our clients need in these very trying times.

But let’s be honest. In recent days, school closures and state ‘shelter in place’ orders across the country have created additional challenges for those who must now juggle both working and learning from home. Recognizing that many are grappling with these new routines, we are providing a list of best practices Discovery employees are using to stay connected.

1. Communicate, communicate, communicate

You can still stay close with coworkers while remaining socially distant. Now more than ever, it is vital to remain transparent regarding projects and work life so that everyone is on the same page and shares the same expectations. This could mean daily brief work huddles, a quick text, more meetings, or in some cases, less meetings. Teams should come together on what will work best for them and what is needed.

2. Establish a workspace and routine

Whether you are working from home alone or with a partner or family, setting up a designated workspace and schedule will help break up the day into more manageable parts. In the office, you might start your morning by grabbing a cup of coffee or tea and prioritizing emails. Replicating that same routine at home can bring normalcy into this ‘new normal.’ If you have children who are tackling distance learning and virtual assignments, make sure they are sticking to their typical school routines (e.g., lunch, recess) as well. And more importantly, set up times to answer any questions. This will help them not only remain engaged but also establish good habits in their later years.

3. Take breaks and stay active

When working from home, it’s easy to get trapped into a mindset that you need to appear available every minute of the day. But breaks are just as important at home as they are in the office or school. Make sure to carve out some time to step away, minimize eye strain, and regroup. You can use this time to take lunch, talk with your partner and/or children, or go on a quick walk or run. You’ll find stepping away can help bring priorities into greater clarity and help you stay more productive throughout the day. And regular exercise is good medicine for both mental and physical health.

It’s hard to predict what lies ahead as the COVID-19 pandemic runs its course. And adjusting to a new routine in a new world can seem overwhelming at times. In the face of these challenges, there are opportunities to invest in connections with each other and transform the way we work. Please take care of yourself, and remember, we will get through this together.

 

Share your work-from-home tips with us on LinkedIn and Twitter.

Learn more about our response to COVID-19.

Discovery Health PartnersTips for staying connected amid COVID-19
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Infographic: Fixing payment integrity at the source

It’s a known fact that improper payments abound in healthcare. Given the effect that eligibility data can have on claims payments, a connected payment integrity approach is essential. Often, challenges arise from multiple sources of data, conflicting or inaccurate data, data integration challenges, manual workflows, multiple reporting systems, and more.

When eligibility errors occur, they affect many payment integrity areas such as coordination of benefits (COB), subrogation, and Medicare secondary payer (MSP) validation. Failing to address these issues leads to incorrectly paid claims, improper reimbursements, or claims that shouldn’t be paid at all—costing your plan millions.

Infographic: Fixing payment integrity at the source

Find out the top three causes of eligibility errors and learn how a connected payment integrity approach can help.

Discovery Health PartnersInfographic: Fixing payment integrity at the source
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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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