Join Cotiviti’s experts on October 24 at 1 pm ET as we analyze the annual Star Ratings for Medicare Advantage plans and offer takeaways to improve future performance and better member outcomes. During this 30-minute webinar, we will: • Discuss highlights from the 2025 Star Ratings • Review planned and proposed CMS measure updates • Provide recommendations for Star Rating improvements Register today! https://bit.ly/3XXcf4G #HEDIS #HealthPlans #payments
About us
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, consumer engagement, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.
- Website
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http://www.cotiviti.com
External link for Cotiviti
- Industry
- IT Services and IT Consulting
- Company size
- 5,001-10,000 employees
- Headquarters
- South Jordan, UT
- Type
- Public Company
- Specialties
- Analytics, Payment Integrity, Payer Liability, Payment Accuracy, Clinical Appropriateness, Coding Compliance, Contract Compliance, Procure-to-Pay, Supplier Audit, Overpayment Recovery, Healthcare, Retail, Pay-for-Value, HEDIS, Risk Adjustment, and Provider Network Performance
Locations
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Primary
10701 S River Front Pkwy, Unit 200
Unit 200
South Jordan, UT 84095, US
Employees at Cotiviti
Updates
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Cotiviti's Marge Ciancetta shares several intricacies of the 2025 CMS Final Rule in our YouTube webinar. Watch on demand to gain valuable insights into its implications for Medicare Advantage Star Ratings. We cover how to: 🔹 Prepare for upcoming changes 🔹 Track member data. 🔹 Maximize improvement measures 🔹 Invest in reducing disparities. Watch and subscribe on the Cotiviti YouTube channel. https://bit.ly/4btG1BN #HealthPlans
Examining the 2025 CMS Final Rule
https://www.youtube.com/
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Medicare Advantage has surpassed original Medicare in total enrollment, capturing over 50% of the market in 2023. However, the path to 64% by 2033 is uncertain and fraught with challenges. Lower payments from CMS, market consolidation, and rising member utilization costs create significant headwinds for future growth, signaling urgent and important challenges for insurers and beneficiaries. https://bit.ly/3ToaRFo HealthLeaders #HealthPlans #payments
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Rising costs and market pressures are driving changes across the Medicare Advantage landscape. Humana plans to exit several markets in 2025, affecting 10% of its membership. Similar exits are expected from competitors like CVS Health and Centene, contributing to an evolving MA market. https://bit.ly/4eh9DDQ Becker's Healthcare #HealthPlans #payments
Humana prepares for 'frustration' over Medicare Advantage changes, 13 market exits
beckerspayer.com
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Are you reviewing NCQA's latest confirmed changes to the #HEDIS program for Measurement Year (MY) 2025? In our latest LinkedIn newsletter, Cotiviti's Samantha Davis breaks down measure retirements, new measures, and changes to existing measures. 📰
Decoding the HEDIS MY 2025 Technical Specifications
Cotiviti on LinkedIn
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This Hispanic Heritage Month, we are proud to celebrate alongside Cotiviti’s Comunidad Adelante Employee Resource Group (ERG). Together, we honor the history, culture, and achievements of Latino and Hispanic communities. Continuing with our spotlight series, we celebrate the iconic Frida Kahlo, a renowned Mexican artist known for her deeply personal and vibrant paintings that explored identity, postcolonialism, gender, class, and race in Mexican society. Kahlo’s work, characterized by its surreal and emotional intensity, has left an indelible mark on the world of art and has become a symbol of resilience and cultural pride.
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Join Cotiviti's experts at the CAHP 2024 Annual Conference in Palm Desert from Oct 21-23. We'll explore how to improve risk adjustment, member engagement, quality, and payment integrity. Whether you're looking for support with reducing #FWA, understanding changing regulations, or engaging your member population, we're ready to discuss how to address your challenges. You can also visit us any time at booth #606 to: 🔹 Try your hand at our "Expert Eye" game to take home an on-the-go travel kit 🔹 Cotiviti Cares will donate $25 to the Boys & Girls Clubs of America for each participant who completes the activity 🔹 Enter a raffle to win Loop Experience 2 earplugs Learn why Cotiviti is a trusted partner to CAHP members and an industry leader with its leading solutions for improving care outcomes while reducing inappropriate costs. https://bit.ly/3XPopv5 #HealthPlans #payments #RiskAdjustment * Note: Open to non-vendor health plan attendees only; giveaways are limited to one per attendee. View Giveaway and Raffle Rules
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See how a large regional health plan turned to Cotiviti to address medical record retrieval issues, resulting in a 6X increase in savings within a year. The plan reduced administrative burdens through AI-enabled chart selection and maintained strong provider relationships. This case study highlights how the strategic application of AI can significantly improve health plan performance without compromising human expertise. https://hubs.ly/Q02Pj_MF0 #healthcare #HealthPlans
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The CMS has finalized the first round of drug price negotiations under Medicare’s new Drug Price Negotiation Program. Announced in August 2024, the new prices for ten selected drugs will take effect on January 1, 2026. The negotiated prices could save Medicare $6 billion, a significant achievement under the Inflation Reduction Act. https://bit.ly/4dMXvLb Health Affairs Centers for Medicare & Medicaid Services #HealthPlans #payments
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The Trusted Exchange Framework and Common Agreement (TEFCA) aims to create a unified framework for health data exchange. The Sequoia Project released the second draft of the Common Agreement in 2024, significantly expanding operational use cases relevant to payers, including quality improvement, risk adjustment, and payment integrity. As Cotiviti's Katie Devlin, DHSc, MS, CPHIMS, explains, health plan leaders must consider if joining a Qualified Health Information Network (QHIN) will help facilitate interoperability. https://bit.ly/3ykQ0vy DOTmed.com, Inc #HealthPlans #payments #healthcare