As Medicare Advantage Grows in Popularity, Health Plans Must Meet Market Demands
According to Medpac, the country's baby-boom generation (born between mid-1946 and 1964) began aging into Medicare in 2011 at a rate of about 10,000 peopl…
IT Leaders Agree: For Successful Investments, Align Tech and Business Goals
Technology, especially next-generation technology, plays a massive role in allowing health plans to embrace change, innovate, and remain competitive. However, …
Many factors can impact the claims payment process. With so many legacy solutions still present in the market, there is significant opportunity for inefficient…
Health Plans See Positive Results With Value-Based Care Reimbursement
Value-based reimbursements have been much debated since both houses of Congress overwhelmingly passed the Medicare Access and Children’s Health Insurance Progr…
The Importance of Patience and Understanding in the Payer Industry
Regional non-profits and health plans wholly owned by hospital systems may be facing challenges in the market today, especially considering COVID-19. Analytics…
Transparency in Coverage Final Rule and Other Regulatory Highlights Health Plans Need To Know
Transparency in Coverage Final Rule
On October 29th, the Transparency in Coverage Final Rule was released and will be published in the Federal Register. We …
For claims and pricing teams, managing fee schedules can be a massive headache.
With Medicare undergoing major quarterly updates as well as policy adjustme…
I know regulations can seem overwhelming, but if you look beyond checking the boxes to ensure compliance, there is so much opportunity. I always try to remind …
No matter how much planning went into 2020, no one could have expected the turn of events this year and its ongoing impact on the health care industry. With to…
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…
