Cotiviti ties together providers and payers, including the top 25 US health plans, that collectively serve 300 million members in the United States. In this video, CEO Ric Sinclair describes how the “friction” between providers and payers can be resolved by leveraging smarter infrastructure like what Cotiviti provides.
Sinclair looks beyond technology and data, even beyond the use of AI, to talk about how an underlying platform can bring together all the expert insights and reduce the waste in health care. Ultimately, he wants to eliminate denials and appeals by “getting it right the first time” in billing. This requires more than the application of AI in “silos,” which he predicts are not sustainable. “Coordination” is a key concept he shares while talking about being a healthcare infrasrtucture company that creates value for its users.
He stresses that Cotiviti connects other solutions, rather than providing another point solution on top of the technology healthcare institutions already use. It aims to apply intelligence earlier in financial and clinical processes, embedding it “where decisions actually happen.” He envisions a future where, even if we can’t eliminate all waste, costs will be “flat or down.”
An interesting moment in our interview comes when Sinclair talks about the ongoing “convergence” of providers and payers. He claims that “payers will continue to move closer to care delivery while healthcare providers increasingly assume financial risk.” Another key idea Sinclair shares is “fairness,” which he applies to patients, providers, and payers alike.
Check out our interview with Ric Sinclair from Cotiviti to learn more about the unique ways Cotiviti is solving real problems by serving healthcare’s infrastructure needs.
Learn more about Cotiviti: https://www.cotiviti.com/
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