Analytics-Driven Insight and Value
Our healthcare system is constantly evolving, and the past few years have seen an acceleration of that trend with an even greater impact on the healthcare market. Complexity is on the rise, creating new challenges for operations, cost management, paying for value and competitiveness.
Cotiviti is acting today to enable our clients to thrive in this new world.
We believe that increasing regulatory oversight, a changing competitive landscape, a tighter economic environment and increasing consumer engagement will combine to place greater emphasis on managing payment accuracy and networks.
A payer’s ability to get payments right the first time will become a competitive advantage. That means getting out ahead of issues like improper coding, documentation, and compliance with policies and agreements. Cotiviti’s vision for the future is to leverage the power of data and analytics across the payment continuum, learning from all that takes place before and after the payment, and using those insights to drive continuous improvement throughout the payer’s operations.
This vision is grounded in a simple principle. The more comprehensively accuracy can be achieved with the right action at the right point along the payment continuum, driven by the right analysis of all the supporting data, the greater the positive impact.
It relies on one of the payer’s most valuable assets: data. Every process, from care delivery and network usage, to claim adjudication and edit, to chart validation, audit and reconciliation produces information. It’s the ability to take that endless stream of data, continuously unlock the value hidden in it, and improve accuracy in every way that sets our direction for the future.
The United States wastes nearly $1 trillion annually on healthcare spending, an estimated $600 billion1 of which can be attributed to unnecessary care and other inappropriate payments. To bend this cost curve, the healthcare market must shift from rewarding volume to rewarding value. Specifically, it must promote High-value Care – care that demands providers make the most efficient and judicious choices that deliver patients the best outcomes while rewarding providers and saving systemic costs.