HMA Vital Viewpoints on Healthcare
Sep 9, 2026 · 31 min · 11 segments
https://youtu.be/DM7u5SUL4h8?si=59ycFac3y2GSPZYR In this episode of Vital Viewpoints on Healthcare, Clint Eisenhower, regional director at Health Management Associates, discusses the critical role of…
Clint EisenhowerGuestJennifer KolomonikoHost
It comes down to the right people getting the right services from the right providers and ultimately getting the right outcomes that they need for their healthcare needs.
I think that a lot of times, fraud, waste, and abuse is set separately, but I've always considered it.
You know, it's really about delivering services to people with good outcomes and getting the bad actors out and keeping them out, you know, while ensuring access to care, good quality care and also reducing patient harm.
It's really about, you know, efficient and effective programs that, you know, serve two purposes.
Obviously, that mission that I mentioned, but also protecting the taxpayers dollars.
What do you think people outside the field or people reading about it in the newspapers, what do they typically misunderstand about what FWA is?
And I've seen that throughout my career, you know, again, working at various levels of government with different organizations.
When I got into program integrity, it was a pretty natural fit because I do feel like eliminating, you know, as much as you can, fraud, waste and abuse is good for everyone.
Once you sort of break it down to what you're trying to accomplish, It's very hard to argue with stopping fraud, waste, and abuse.
So I think, you know, that's sort of one way to shift the narrative is not fraud word being a bad word necessarily, but more so it's about actually serving people and getting those bad actors out.
You know, fraud leads the FWA sequence, but fraud's only a very small part.
Waste and abuse are far more prevalent and far more costly and far more impactful on the quality of care.
And then the last thing I'll just say is I've always felt like program integrity really is a team sport.
um the federal government plays a role states play a role health plans providers everybody beneficiaries or members themselves plays a role and so you know it's really um there's always like a program integrity function you know there's a center for program integrity at cms there's a medicaid fraud control unit in state government you know health plans have sius Those are the functions that do this work.
And if you work on it across organizations, but also at the various levels of the health care ecosystem, it goes much better and ultimately achieves the goals.
So I think those are probably the big three is let's not make it a negative topic.
Let's make it a means to an end of really serving people in the right manner.
It comes down to the right people getting the right services from the right providers and ultimately getting the right outcomes that they need for their healthcare needs.
I think that a lot of times, fraud, waste, and abuse is set separately, but I've always considered it.
You know, it's really about delivering services to people with good outcomes and getting the bad actors out and keeping them out, you know, while ensuring access to care, good quality care and also reducing patient harm.
It's really about, you know, efficient and effective programs that, you know, serve two purposes.
Obviously, that mission that I mentioned, but also protecting the taxpayers dollars.
What do you think people outside the field or people reading about it in the newspapers, what do they typically misunderstand about what FWA is?
And I've seen that throughout my career, you know, again, working at various levels of government with different organizations.
When I got into program integrity, it was a pretty natural fit because I do feel like eliminating, you know, as much as you can, fraud, waste and abuse is good for everyone.
Once you sort of break it down to what you're trying to accomplish, It's very hard to argue with stopping fraud, waste, and abuse.
So I think, you know, that's sort of one way to shift the narrative is not fraud word being a bad word necessarily, but more so it's about actually serving people and getting those bad actors out.
You know, fraud leads the FWA sequence, but fraud's only a very small part.
Waste and abuse are far more prevalent and far more costly and far more impactful on the quality of care.
And then the last thing I'll just say is I've always felt like program integrity really is a team sport.
um the federal government plays a role states play a role health plans providers everybody beneficiaries or members themselves plays a role and so you know it's really um there's always like a program integrity function you know there's a center for program integrity at cms there's a medicaid fraud control unit in state government you know health plans have sius Those are the functions that do this work.
And if you work on it across organizations, but also at the various levels of the health care ecosystem, it goes much better and ultimately achieves the goals.
So I think those are probably the big three is let's not make it a negative topic.
Let's make it a means to an end of really serving people in the right manner.
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