2027 Advance Notice – Stars Deep Dive
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
2027 Advance Notice – Risk Adjustment Deep Dive
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
2027 Advance Notice – Rate Setting Deep Dive
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
2027 Medicare Advantage and Part D Advance Notice – Deep Dive
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
2027 Medicare Advantage and Part D Advance Notice
Practices trying to improve their viability or considering or pursuing an equity transaction should look at ‘low hanging fruit’ opportunities for commercial payment increases.
Are Copper Plans the Solution for Affordability?
President Trump introduced the concept of a copper plan as a solution to healthcare affordability. But is it a solution? Yes, copper premiums will be lower than what is currently offered...
One Size Doesn’t Fit All: Industry-Based Utilization Patterns in Health Insurance
Designing health benefits as if they were one-size-fits-all is a bit like issuing steel-toed boots to accountants or medical scrubs to long-haul truckers—it sounds equitable until you look at the bill.
Is a Tax Credit System the Cure for U.S. Healthcare?
The U.S. healthcare system, marked by extraordinary technological capability and deeply rooted inequities, has reached a critical inflection point.
Is Self-Funding the Right Move?
How Employers Should Evaluate the Shift from Fully Insured Health Plans. Self-funding is an alternative approach where employers directly manage and fund healthcare claims, allowing greater transparency, flexibility, and control over healthcare costs...
Denial Rates: Fact or Fiction?
The killing of the CEO of a major health plan has again highlighted the issue of denials and denial rates in today’s healthcare marketplace. It is fairly common in today’s marketplace to criticize those plans with higher than average denial rates.