Diving Deeper: Proven Fraud Solutions for Maximum Results

While many SIUs depend on referrals, unfortunately, this practice results in the team’s recovery opportunities mainly getting the small fish, the lesser cases with little effect in the overall ocean of fraud. What if you had the tools to challenge the status quo and cast the net to catch the bigger fish – those high quality cases that really make a difference?

Dive deeper into fraud solutions in this one-hour complimentary webinar at 2 p.m. Eastern, Tuesday, Nov. 28. HMS’s Jean Lyon and Ed Hewitt use a combination of analytics, algorithms, and a new scheme model to demonstrate how successful analytics are not only possible, but how they can become the new model for best practices in SIU.

In this presentation, attendees will:

  • learn how to internally build the SIU brand;
  • leverage key investigative opportunities; and
  • capture success with new best practices.
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Total Population Management

Join HMS and MHPA for a webinar on Total Population Management, 3 p.m. EST, Wednesday, Nov. 15.

To effectively bend the health cost curve, identification of risk is required across your entire population. While management of the high risk population accounts for 50% of your medical costs, that population is fluid. Early identification of pre-conditions such as pre-diabetes or obesity, can help you manage those from escalating into more serious conditions. Total Population Management provides tools to assess and manage risk in a coordinated platform, engaging your entire population.

Keys to achieving Total Population Management are knowing your members, engaging your members and coordinating care to manage health outcomes. Previously a challenge, HMS can now provide transparency into your total population and management through coordinated tools such as population risk intelligence, member engagement engine, and population health technology platform.

Join HMS’s Gary Call, MD, Chief Medical Officer; Ellen Harrison, RN, MBA, SVP Market Strategy and Consulting; Jill Field, Sr. Director Population Health Technology; and Jennifer Butler, Sr. Director Total Population Management Marketing; as they share with attendees how to:

  • Effectively manage all of your members on a personal level with increased flexibility using fewer resources to drive immediate results;
  • Identify risk in your general population and monitor existing conditions to support adherence in an automated approach; and
  • Activate members through a personalized conversation across multi-channels to build member profiles and assess health status, identify barriers, close gaps in care and increase member retention.
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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
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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
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