Sagility Health

As outlined in our previous blog, improper payments are no longer isolated incidents — they represent a systemic breakdown in how payment integrity is executed. The gap between detection and recovery is where most value is lost.

Healthcare leaders know a hard truth: medical care alone explains only a fraction of health outcomes. Up to 80% of what determines health happens outside the four walls of the clinic shaped by housing stability, access to...

Across the United States, Medicaid and Medicare cases of improper payment are surfacing with increasing frequency and scale of impact. From improper billing and undocumented services to upcoding and duplicate claims, these cases span federal programs and state-administered Medicaid plans. Once perceived as isolated mistakes, these cases are now being exposed as a systemic cha...