What is on the horizon for healthcare payer technology in 2025? In this annual report, ClarisHealth experts review the trending drivers – and associated opportunities – so health plans can innovate payment integrity while minimizing risk.
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Maximizing Opportunity with 2025 Healthcare Payer Technology Trends
Buying payment integrity technology: 6 considerations
More health plans see the value in reducing administrative complexity to improve costs and payment accuracy. This step-by-step guide for payment integrity leaders buying enterprise technology ensures you reach those goals.
Payment Integrity Leaders Reveal What Will Move the Industry Forward
Payment integrity leaders from the country’s top health plans take time to collaborate at POP Conference 2024. They find strength in community, innovative ideas, and a focus on 4 primary industry drivers.
Improving Payment Integrity with a Building Blocks Methodology
Payers need a proven framework for payment integrity to create financial value, handle change, and engage at the highest levels of organizational strategy. This 5-step methodology works whether the directive is accelerating growth, building from scratch, or somewhere in between.
Payers Reduce Administrative Costs by Going Back to Basics with Payment Integrity
In the face of economic and hiring constraints, payment integrity leaders are prioritizing these 4 best practices to shift to an enterprise strategy that offers proven value.
Health Plan Leaders Speak Out on Building the Payment Integrity Organization of Tomorrow
Whether or not health plan leaders implement a fully centralized PIO, sharing information on an enterprise payment integrity technology platform helps overcome challenges and meet strategic opportunity.
Modernizing the SIU to Combat Healthcare FWA
For more than a decade, the SIU has relied on reactive business models. But with the rapid gains that artificial intelligence has made, health plans are beginning to embrace more adaptive technology, working smarter to deliver tangible results.
ClarisHealth Named a Preferred Vendor by the Association for Community Affiliated Plans
ClarisHealth named a preferred vendor by the Association for Community Affiliated Plans, provides unique payment integrity and FWA technology platform for ACAP member Safety Net Health Plan digital transformation goals.
Strategies to Move Your Payment Integrity Program Prospective
Payment integrity evolves into a more strategic function for health plans in order to reduce overall healthcare expense. Prepay drives greater cost savings but can be difficult to achieve. Here, we share strategies that can enable prospective cost avoidance programs...
“The Great Pause” Brings Unyielding Uncertainty to Medical Loss Ratios but Also Opportunity
Are better-than-expected medical loss ratios in 2020 setting up payers to take a severe hit on profit margins in 2021? Go on offense by making moves that feature these 4 risk-mitigating hallmarks. Six months into the novel coronavirus pandemic in the U.S., the crisis...
Health Plans Launch Innovative Solutions to Respond to Mental Health Crisis
Transparent data sharing supports seamless care coordination, relevant outreach that mitigates effects of chronic conditions. The novel coronavirus pandemic continues its near-perfect record as a harsh but effective teacher for the healthcare industry as it...
Healthcare Interoperability Poised to Solve COVID-19’s Big Data Crisis
Coronavirus highlights power of big data and the need for interoperability to improve population health. How can health plans lead the way? What’s the single biggest weapon used by government, pharma, academic researchers, healthcare systems, and health insurers alike...
Your health plan’s best crisis response strategy? Innovation.
Health plans set themselves up for success – during a pandemic and beyond – by pursuing advanced technology to engage providers, satisfy members, and improve population health initiatives. The healthcare system is on the front lines of the novel Coronavirus pandemic,...