Thu, 11 May 2017
MediStrategy with Kip Piper Episode 09: Fighting Healthcare Fraud and Ensuring Medicaid Program Integrity: Interview with Bill Lucia, Chairman and CEO, HMS Summary “Fighting health care fraud is like playing Whac-A-Mole.” Our nation’s $3.2 trillion healthcare system is a complex beast. To ensure its integrity, we must combat a range of issues – from unintentional errors to criminal activity. Today’s guest is an industry leader in leveraging data analytics and the benefit of a national perspective to identify bad actors and ensure that Medicaid is the ‘payer of last resort.’ Bill Lucia is Chairman and CEO of HMS Holdings, the nation’s largest and most successful company dedicated to providing the broadest range of healthcare cost containment solutions to help purchasers, plans, and at-risk providers improve performance. HMS works with 45 state Medicaid programs, 250 health plans, Medicare, large employers, and provider organizations to help contain costs and protect our nation’s healthcare system from fraud, waste, and abuse. Lucia joined HMS in 1996, becoming chairman, president, and CEO in 2009. He is responsible for leading HMS through the evolving healthcare landscape, demonstrating the ability to formulate and implement key strategic initiatives. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed Topics Covered The mission of ensuring the integrity of nation’s healthcare system by reducing costs and removing fraud, waste, and abuse. The complex nature of the Medicaid system:
How HMS works to ensure program integrity in Medicaid:
How technology, know-how, and analytics are used to:
How pattern recognition is used to detect inaccuracies and fraud in claims:
The significant return on investment from HMS program integrity work:
How to make the case for preventative measures (vs. recovery dollars):
How HMS has built the industry standard with regard to coordination of benefits:
How to leverage advanced analytics:
HMS policy recommendations to Congress and States:
Connect with Bill Lucia and HMS Resources Mentioned HMS Report: Effective Cost Management for Medicaid Connect with Kip Piper, Host of MediStrategy About MediStrategy: The MediStrategy podcast offers informative interviews with healthcare leaders and insights on hot business and policy issues in Medicare, Medicaid, and health reform. Health executives, policymakers, entrepreneurs, authors, and other influencers share challenges and opportunities in America’s rapidly changing $3.2 trillion health care system. MediStrategy is hosted by Kip Piper, a top expert on Medicaid, Medicare, and health reform. A prominent consultant, speaker, and author, Kip Piper advises health plans, state Medicaid agencies, hospitals and health systems, provider associations, life sciences companies, and investment firms. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed
Direct download: MediStrategy_with_Kip_Piper__Ep_09_-_Bill_Lucia_HMS.mp3
Category:general -- posted at: 4:25pm EDT |