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Navigating risk adjustment across multiple lines of business isn’t just complex, it’s a balancing act of shifting regulations, diverse populations, and evolving models. In this episode, we break down the key differences between Medicare Advantage, Medicaid, and ACA, and explain why understanding th…

Season 4 Trailer

This season on Current Trends for Payers, we’re highlighting guest experts in emerging technologies and operational strategies that health plans need to stay agile and competitive. We’ll dig into what’s working and what’s coming next, with candid conversations from executives, product, and business…
CMS has issued a major announcement that’s reshaping how Medicare Advantage plans approach risk adjustment audits. A new era of oversight is here. Defined by tighter timelines, expanded audit scope, and heightened expectations around data accuracy. Along with the announcement, a detailed compliance…

No Analysts Needed

Health plans continue to face operational delays due to fragmented systems and an over-reliance on manual reporting cycles. While data analysts work across multiple platforms to produce static reports, the insights often arrive too late to support real-time decisions. This episode explores why trad…
What if your contact center could do more than answer questions? What if it could predict needs, detect fraud, translate languages in real time, and coach agents as they speak to members?  In this episode, explore how AI is transforming call centers into strategic experience hubs. From agent assist…
Vastuuvapautusilmoitus: Tälle sivulle upotettu podcast ja kuvitus ovat peräisin Sponsored by HealthEdge:ltä, joka on sen omistajan omaisuutta, eikä se ole sidoksissa Listen Notes, Inc:n tukemaan.