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Harnessing the Full Power of Data Analytics: A Holistic Approach to Cost Containment

Harnessing the Full Power of Data Analytics: A Holistic Approach to Cost Containment

Feb. 23, 2017

The healthcare industry has entered a tumultuous new age filled with changing regulations and new opportunities for growth. Payment reform, an expanding population of insured individuals, and a renewed focus on value-based payments have undoubtedly shifted the healthcare landscape in new and innovative ways.

But change comes at a cost, and in the United States, with a new wave of sicker individuals accessing medical care, healthcare costs have reached an all-time high. Already topping $3.2 trillion, by 2025 healthcare spending is estimated to exceed 20% of the gross domestic product.

Join HMS Chief Medical Officer Gary Call, M.D., as he addresses the holistic approach to healthcare reform. In this complimentary, one-hour webinar including a Q&A session, Dr. Call will discuss:

  • Healthcare payment landscape
  • Large data sets
  • Pre-pay claim review
  • Fragmentation
  • Holistic approach
Replay Webinar Recording

Painful Price, Potential Promise: Using Analytics to Combat Compound Rx Fraud

The cost of compound pharmaceuticals continues to skyrocket – as much as 18 times what it was just three years ago. Our healthcare system has left the door open for these high price tags and for the unscrupulous to prey on the vulnerable with “miracle cures” or useless dietary supplements. The schemes are endless, with significant risks to patients and their loved ones, even resulting in death.

Learn more about the issue in this webinar:

Presenters: Bill Mahon, president, The MAHON Consulting Group;
and Jean Lyon, RN, MS, vice president of product innovation, HMS

Replay webinar recording.

Adventures in Change: Navigating the Affordable Care Act’s Effect on Medicaid Coordination of Benefits

Dec. 7, 2016
The Affordable Care Act (ACA) changed the landscape of Medicaid eligibility and enrollment, forcing Medicaid agencies and health plans to reexamine how to best maximize funding sources to provide care for new populations. Six years after the ACA’s implementation, Medicaid programs still face a dynamic environment in ensuring Medicaid remains the payer of last resort.

Based on this popular MHPA2016 breakout session and new research including both the perspectives of Medicaid MCOs and Medicaid consultants, join us for:

Adventures in Change

Navigating the Affordable Care Act’s Effect on Medicaid Coordination of Benefits

Presenters: Kristen Ballantine, HMS Vice President, Government Relations AND Frank Mincieli, HMS Senior Director, Enterprise Data Quality

This webinar will address:

  • How Medicaid expansion demographic changes effect coordination of benefits activities, including demographics and the employer market
  • The impact of data sharing initiatives on Medicaid coordination of benefits efforts
  • How legislation such as state-level Deficit Reduction Acts provide Medicaid plans more data access and savings opportunities
  • Best practices in coordination of benefits post the ACA
  • How the 2016 CMS Medicaid Managed Care rule will impact the way plans share data and coordinate benefits
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The New Medicaid Managed Care Rule: Practical Guidance From Multiple Viewpoints

Sept. 27, 2016

Join panelists James Golden of Centers for Medicare and Medicaid Services (CMS), Michael McCoy of New Jersey State Comptroller Office, and Alexander Shekhdar of Medicaid Health Plans of America as they share their expertise and viewpoints related to the recent federal Medicare managed care rule regulation and how it might influence practices and approaches on program integrity.

Moderated by Penny Thompson, former deputy director of CMS’ Centers for Medicaid and CHIP Services and a current commissioner of the Medicaid and CHIP Payment and Access Commission (MACPAC), this 50-minute HMS-sponsored webinar is a recording of an original presentation to attendees at the 32nd annual National Association for Medicaid Program Integrity (NAMPI) Conference in Baltimore, Md.

The goals of this session include:

  • Provide overview of the rule’s provisions concerning program and financial integrity
  • Promote understanding of what the federal government hopes to accomplish
  • Provide insight on how states and plans view the regulations and steps to respond
  • Generate discussion and thoughts on how these provisions will affect you
Replay Webinar Recording

Curing Employee Benefits Blues: Solutions That Work

Mar. 10, 2016
When employee benefits costs weigh you down, lighten your load!

Join David Hines, benefits director of Metropolitan Nashville Public Schools; and Alison Walker, HMS sales manager, as they highlight real-world benefits-saving applications for superintendents, human resources professionals, and other school stakeholders.

The webinar shows how AASA School Solutions partner HMS has helped hundreds of districts recognize significant employee benefits savings through two key solutions:

  • Dependent Eligibility Verification
  • Medical Plan Audit

Find out how these mainstream approaches save money without changing the level of benefits offered.

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The Painful Side-effects of Opioid Fraud: Fighting the Phantom with Proactive Approaches to Analytics, Investigations, and Partnerships

Mar. 3, 2016

Do opioid abuse investigations leave you with a headache? You’re not alone. During this webinar, Ed Hewitt, HMS program integrity solution consultant, discusses:

  • A more proactive approach to analytics, investigations, and partnerships
  • New geospatial analytics, fresh methods to curb doctor shopping, and preemptive relationships with pharmacies and other partners to deliver outsized results
  • Practical ways to fight opioid fraud — and to help those suffering from addiction
Replay Webinar Recording