Maximize Practice Value with Enhanced Contracting Strategies
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
Healthcare Affordability Index: 2024
Reducing Healthcare costs continues to be a national topic of concern. Medicare’s expansion of value-based care initiatives will likely help improve healthcare affordability...
Actuaries to the Rescue: Recovery from Bankruptcy
Bankruptcies are on the rise for healthcare companies backed by private equity and venture capital[1]. A recent study discovered that PE-backed bankruptcies in 2023 were more than double compared...
Measuring Health Care Innovator Value
The US healthcare system is known for its high costs compared to other developed countries. Several factors contribute to this, including administrative expenses, pharmaceutical prices, and the...
The Importance of IBNR in Self-Funded and Traditional Health Plans
Understanding and accurately predicting future liabilities is crucial to the sustainability and success of insurance companies and self-insured employer-sponsored health plans...
Inflation Reduction Act Pharmacy Provisions – Implications and Other Changes
This is the final article in a three-part series[1],[2] discussing the impact of the Inflation Reduction Act (IRA; H.R. 5376)[3] provisions. First, we’ll cover the Medicare...
Inflation Reduction Act Pharmacy Provisions – Part D Changes
This is the second[1] in a three-part series discussing the impact of the Inflation Reduction Act (IRA; H.R. 5376)[2]provisions. Here we’ll look deeper into the changes coming to Medicare...
Diagnosis Co-Occurrence
Patients with multiple chronic diseases constitute a small minority of the total population but the majority of healthcare costs. These patient’s healthcare needs cannot be understood...
Understanding Provider Financial Losses in Value-Based Contracts
The shift from fee-for-service (FFS) healthcare models to value-based care (VBC) has been a monumental transformation in the healthcare industry. However, as this transition unfolds, it has added significant complexity to the healthcare system...
Drug Price Negotiation Program
This is a follow-up to a prior Inspire Blog article[1] we posted and the first of three we’ll be posting now that more information, detail, and realities have come to pass; this post delves deeper...