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States are moving to reduce Medicaid payments for applied behavioral analysis therapy as spending on the autism treatment surges, KFF…
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Payment integrity teams are being asked to do more with more complexity, more data and less room for error. The opportunity is not to replace existing workflows. It is to make them smarter. AI can help health plans act earlier,…
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Presenters
Arun Rangamani
Senior Vice President, Payment Services, AI and Analytics Solutions and Services, EXL
William O’Neil
Vice President, Healthcare Solutions, EXL
Healthcare finance teams are navigating volatile reimbursement models, fluctuating census levels and persistent capital constraints. But many finance teams are still working across disconnected systems — where all of it rarely aligns. When workforce forecasts, patient demand and financial planning…
Presenters
David Richardson
Regional Manager and Healthcare Specialist Prophix
Michael Ciprietti
Head of Platform Enablement Unify
In high-stakes environments, confidently held misinformation is a measurable risk. An employee can complete required training, pass a quiz and still lack the knowledge needed to perform safely under pressure. Microlearning improves access. Generative AI accelerates content creation. But neither…
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Rising costs, specialty drug pressure and Medicare Advantage headwinds are making sustained medical loss ratio performance harder to achieve. At many health plans, risk, quality, network and value-based initiatives are still managed through disconnected analytics tools or spreadsheets. This fragmentation…
Presenters
Rebecca Anderson, LMSW
Director, Community Health, Blue Cross and Blue Shield of Kansas City
Trenor Williams, MD
CEO and Co-Founder, Socially Determined
Justin Neece
Chief Growth Officer, MedeAnalytics
Oceans Behavioral Hospital—Lubbock (Texas), part of Plano, Texas-based Oceans Healthcare, has launched a virtual outpatient program aimed at expanding access to behavioral healthcare services across West Texas. The program offers structured, evidence-based care in a virtual setting, allowing individuals to remain…
Sacramento, Calif.-based Crestwood Behavioral Health has appointed David Bond as program chief for behavioral health. Mr. Bond joins the provider after several years working on the payer and policy side of behavioral health, according to a March 11 LinkedIn post.…
Lebanon, N.H.-based Dartmouth Hitchcock Medical Center has created a department of social work to enhance training and career advancement opportunities for those in the profession. The department will provide career development pathways, educational opportunities and professional support for social workers…
Plano, Texas-based Oceans Healthcare has appointed Jamie Higgins as CEO of Oceans Behavioral Hospital in Opelousas, La. In 2022, Ms. Higgins joined Oceans Healthcare at Haven Behavioral Hospital-Phoenix, where she served as director of clinical services, according to a Feb.…
San Francisco secured nearly $100 million in Proposition 1 funding to expand behavioral health treatment capacity across three sites, including a project at University of California, San Francisco Health Hyde Hospital. The funding includes $70.2 million to add 50 locked…
At OSF HealthCare based in Peoria, Ill., digital therapeutics are connecting patients to behavioral health services beyond hospital walls — and driving results, with patients seeing more than 50% improvement in patient health surveys, or PHQ-9 scores. The system uses…
