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A health care payer’s provider network is the front line of exposure to risk. As health care reform continues to evolve at the speed of technology, stakeholder demands and an engaged health care consumer, RISE NASHVILLE brings together more than 1,200 targeted executives and senior level management individuals from Medicare Advantage, Medicaid; and commercial health…
by Jan Smith Reed Underwriting for medical professional liability carries significant risk exposure. Technology has greatly altered the process and will continue to influence workflow and strategy. With digital labor (automated underwriting), data analytics, AI, and predictive behavior modeling driving the future of underwriting, it is easy to get caught up in what looks like…
Compliance is a word that causes some to cringe. The thought of meeting regulatory and corporate standards through compliance methodology can be daunting—just ask a compliance officer. There are myriad moving pieces when it comes to compliance. First, there is the consideration of regulatory requirements that shape corporate and best practices guidelines. Then add into…
Bringing provider transparency into the quality measures equation is an overlooked but vital step in the focused effort to assure quality health care while controlling costs. Dr. Allen Weiss, president and CEO of NHC Healthcare System, Naples, FL said in his Guest Commentary on Modern Healthcare that the U.S. spends 17.8%—the highest ratio of GDP…
