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Health plans face financial decisions every day that impact their bottom line. What terms will make a new provider contract more beneficial? How should a new p…
The alignment of business and technology, especially in this industry, is becoming increasingly important. To be successful, technology leaders must understand…
Keeping Information Secure Remains Top Of Mind For Health Plans
Security incidents that involve customer or member data are completely debilitating for a health plan’s business. On average, a data breach costs hea…
Challenge The Inefficient Status Quo In Claims Administration
Today, many health plans use homegrown or legacy systems that assume manual work as part of the process. With limited automation and integration, organizations…
Systems That Easily Integrate Necessary For Improving Claims Accuracy Rates
Once a health plan finalizes a claim, they do not want to go back and fix it retroactively. Claims accuracy rates improve productivity, reduce errors, and are …
So many regulations are intertwined; health plans cannot ignore the ones that may seem insignificant. Every year these smaller regulation changes get bigger.
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If an organization is open to change, it will always result in a successful, smoother implementation of new technology.
For those who are reluctant to chang…
As health plans continue to compete for membership, I have seen a shift in the market toward a focus on member-centricity. Health plans competing to aggressive…
Measuring IT Investment From A Risk Mitigation Approach (Rather Than ROI)
Most buyers of healthcare/health insurance IT are, by nature, risk-averse. There are very legitimate reasons for concern: IT infrastructure is expensive, compl…
The Ongoing Search to Reduce Costs, Increase Quality
Those working in health plan operations are always in the fury of the moment. They are focused on what is the next emergency. How many people is that going to …
Value-Based Care Requires Payer-Provider Collaboration
Payers are increasingly incorporating social determinants of health (SDoH)— biology and genetics, individual behavior, social environment, physical environment…
Leveraging Real-Time Data for a Meaningful Customer Experience
Health plans know that better member engagement can lead to improved health behaviors as well as enhanced customer satisfaction. That is why they are investing…
