Cotiviti Launches Tools to Accelerate Health Plan Quality Interventions
Event summary
- Cotiviti introduced Concurrent Quality and expanded Engagement Hub capabilities to help health plans identify care gaps earlier in claims processing.
- The solutions aim to reduce retrospective work and coordinate interventions across quality, risk adjustment, and member engagement programs.
- NCQA certified Cotiviti's Digital HEDIS® measures for 2025, supporting the shift to digital quality measurement.
- Administrative costs account for 25% to 35% of U.S. healthcare spending, according to the American Hospital Association.
The big picture
Cotiviti's new capabilities address the growing need for health plans to act on quality opportunities earlier, aligning with NCQA's shift to digital quality measurement. The solutions aim to reduce administrative costs, which account for a significant portion of U.S. healthcare spending. By embedding alerts into billing workflows and coordinating outreach across programs, Cotiviti seeks to improve performance across the care continuum.
What we're watching
- Regulatory Compliance
- How NCQA's transition to digital quality measurement will impact health plans' adoption of Cotiviti's solutions.
- Operational Efficiency
- Whether Cotiviti's tools can significantly reduce administrative burden and improve care coordination.
- Market Differentiation
- The pace at which Cotiviti can strengthen coordination between health plans and providers to drive value-based care.
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