Enterprising healthcare  

Health Plan Dialogue


Jan. 4, 2017


drug fraud


Combat Compound Drug Fraud


The cost of compound pharmaceuticals continues to skyrocket – as much as 18 times what it was just three years ago. Our healthcare system has left the door open for these high price tags and for the unscrupulous to prey on the vulnerable with “miracle cures” or useless dietary supplements. The schemes are endless, with significant risks to patients and their loved ones, even resulting in death. Learn more in this white paper: "Curbing the Cost of Compound Drug Fraud: Combat Negative Consequences with Data Analytics."


adventures in change


Adventures in Change


The Affordable Care Act (ACA) changed the landscape of Medicaid eligibility and enrollment, forcing Medicaid agencies and health plans to reexamine how to best maximize funding sources to provide care for new populations. Six years after the ACA’s implementation, Medicaid programs still face a dynamic environment in ensuring Medicaid remains the payer of last resort. Discover more in this webinar: "Adventures in Change: Navigating the Affordable Care Act’s Effects on Coordination of Benefits."


case study


High Yields


Payers of all sizes feel the impact of improperly paid claims – an estimated $1.1 trillion-a-year problem nationwide. As many plans have discovered, it takes an aggressive stance by leadership and an experienced, qualified partner to counteract the losses and generate significant recovery opportunities. HMS, with its established reputation for holistic health plan cost containment, worked with one payer to implement a suite of payment integrity audits, resulting in recovery of over $43 million. Find out how with this case study. 

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