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Health Insights
Utilization Management (UM) is used by payers and delegated providers to ensure that patients get the right care at the right time in the right place in a cost-effective manner while maintaining high quality patient care and services. Many programs have recently come under fire because of the administrative impact the process has on health care providers due to a burdensome process many of these groups employ to get a process approved.
Read the article by Jerry Frank, MD and Carlene Zincke, RN
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As of April 1, 2023, states began terminating members from Medicaid plans based on eligibility or due to inaccurate or incomplete eligibility information on file with their counties. Learn about these five considerations on Medicaid Redetermination and how they can impact your organization.
Read the article by Evan King and
Allison Blakemore
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For the Medicaid population, the promise of integrated data placed at the right point in the care delivery system isn’t just a technological marvel, but also has the potential for profound human impact.
Read the article by Dan Serrano and
Carlene Zincke, RN
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Join COPE Health Solutions and ATI Advisory as we discuss Dual Eligible Special Needs Plans (D-SNPs) and the dual enrollment of eligible individuals in Medicare and Medicaid. Our speakers will discuss the benefits of dually eligible plans, cost sharing protections covered under D-SNPs, how D-SNPs affect healthcare utilization and the opportunities and challenges of integrating care through D-SNPs.
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About COPE Health Solutions
COPE Health Solutions is a national tech enabled services firm powering success in risk arrangements and development of the future workforce for payers and providers.

Our team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers, de-risking the roadmap to advanced value-based payment.
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