Fraud in Value-Based Care Programs

Fraud in Value-Based Care Programs

Prevent fraud with our software from Ensure Data Solutions is perfect because  Fraud in managed care programs increases costs for the government – sometimes substantially.  As the amount of taxpayer money spent on managed care increases, so does the importance of...
Rx Utilization Factors

Rx Utilization Factors

Ensure Data Solutions always said that utilization has become a key factor when we talk about reducing cost of healthcare and prescription drug expenses is big part of it. Overutilization leads directly to higher health care costs. There are many reasons...
Medicare Advantage plan changes coming for 2022

Medicare Advantage plan changes coming for 2022

The greatest uncertainty is members’ health status, which could impact MA organizations’ bidding submission process for 2022. Fortunately, fully vaccinated members are likely to resume in-person care this year, which means MA plans can expect a more consistent...
Fraud is mounting in Medicare Advantage

Fraud is mounting in Medicare Advantage

Can a patient have and not have diabetes at the same time? According to private insurers participating in the Medicare Advantage program, the answer is yes. The data architecture of Medicare Advantage is vulnerable to fraud perpetrated by the Medicare Advantage...