Business Strategy

Retail clinics emerge as a way to satisfy the growing demand for healthcare created by the newly insured under the ACA, but contrary to expectations, they do not appear to be leading to meaningful reductions in low-acuity ED visits.

CMS announced changes to how Medicare pays for primary care. Here’s 5 things to consider.

: Remembering to engage in healthy behavior can often slip to the bottom of our list of priorities. In a world where we need to be reminded and motivated to be the healthiest version of ourselves, the right nudges at the right time can help us get there.

Humana’s value-based reimbursement model with physicians has helped to improve care quality and health outcomes for its Medicare Advantage (MA) program members.

Here’s a three-pronged approach to improve adherence program efficiency that leverages predictive data analytics, hospital on-site pharmacies and post discharge follow-up evaluation to achieve real, measurable results.

The results of Geneia’s year-long study – a savings of $8,375 per patient and a slowing of disease progression – demonstrate that remote patient monitoring is a wise investment for payers.

Awareness of biosimilars is high, but there are some gaps to be filled, according to a Biosimilars Forum study.

A new Express Scripts report highlights risk reporting gaps and offers advice for plans looking to close those gaps to ensure accurate risk payments

In this commentary, Gerard J. Wedig of Simon Business School discusses the many possible implications of a Trump presidency.

ACA repeal/replace was a Congressional Republican cornerstone, so there will be lots of pressure to move quickly. But that may be easier said than done.

A new report highlights the highest uninsured rates by state. Is your state among the top 10?

Healthcare industry leaders and policy analysts discuss how the election results could impact healthcare.

Failure to report accurate data can result in significant penalties for Medicaid managed care plans.

Most Americans have health insurance today, but according to new research from Xerox, only three out of 10 are very confident that their current health plan is the best fit for their family.

Industry leaders share their go-to strategies.

PwC report finds most primary care teams not designed to optimize care. Here’s how to mobilize non-physicians to create a care dream team.

Alcohol and drug dependency treatment goals can tied to an insurer’s pay-for-performance incentive program. Here’s how.

Lay the groundwork for bundled payment; here are three areas in which technology can play a role.

How to really understand patient experience and improve outcomes. Here are five tips to help you create a culture of excellence.

Here are some of the latest precision medicine approaches being used by managed care organizations, health systems and academic medical centers across the U.S.

As the industry moves toward value-based care, medical education must keep pace.

After carefully considering its promise and consulting with experts, Independence Blue Cross this year became the first major insurer to provide coverage for certain members who are seeking access to whole genome sequencing.

Health plans are using advanced analytics to improve physician engagement,performance and satisfaction in ACOs and risk-sharing contracts.

Drugs will be provided to health plan members on clinical trials free of charge.

A recent survey suggests suggest a lack of access to appropriate commercial payer arrangements is causing health systems to explore alternatives.