Business Strategy

A new database helps payers understand which genetic tests are available, which genes they test for, and which tests would be appropriate to use to inform patient management.

Here are five ways to use big data and predictive analytics to get insights about members and create a personalized member experience.

A new study highlights why vaccination costs should be a top consideration when evaluating benefit offerings.

Here’s how you can take advantage of this breathing room.

Study shows that an integrated pharmacy approach with community mental health centers produces higher adherence rates and lower overall healthcare costs.

As external pressures such as government regulations continue to mount and alter the approach to deal making in the healthcare sector, there are five things health services executives should watch.

Where do the capabilities of healthcare technology end and the need for the human hand begin to deliver top value for managed care executives?

The proposed HHS Notice of Benefit and Payment Parameters for 2018 indicates CMS is focusing on refining the risk adjustment model to better compensate plans.

The opioid crisis in the U.S. is a multidimensional problem requiring a multistakeholder solution.

Managed Healthcare Executive asked industry experts to share their favorite mobile apps for healthcare. Here’s 13 of their top picks.

Managed Healthcare Executive recently invited a panel of experts representing different sectors of the healthcare industry to explore specialty pharmaceutical challenges and identify potential solutions.

Learning how to appreciate the value of experiences is key for these execs, who share their biggest career mistake was and how they learned from it.

Managed Healthcare Executive conducted its first-ever managed care pharmacy survey during the second quarter of 2016 in partnership with Access Market Intelligence. Here’s a look at some of the key findings, with experts weighing in on the results.

As health plans work to develop and price products for the 2017 open-enrollment cycle-beginning November 1, 2016, it looks like some premiums are set to rise substantially.

Expert: Expectations are high that biosimilars can control overall biologic cost growth.

Here’s what to expect from Blue Shield of California’s four-day closure over Obamacare losses.

CMS expands bundle payment programs by adding cardiac care. Here’s how you can contribute to providers’ success.

As Aetna bows out of health insurance exchanges, more questions about viability are cropping up. Find out which other plans are exiting the health insurance exchanges.

Outsourcing means giving up a vital part of what you do as a business, so it’s a strategy that should be approached carefully. On the other hand, not outsourcing could also threaten the success of your organization.

Executives need to ask themselves four key questions to mitigate the negative impact of rising drug costs.

A survey from Vizient of CMS previews reports from member hospitals. Here are the findings.

To generate leads, convert prospects and keep members engaged, health plans must employ a high-touch, multi-channel healthcare marketing strategy which will be much more effective and enroll members who may have not otherwise done so.

New NCCN guidelines include new technology as an option for patients’ annual screening.

Many healthcare organizations lack the necessary governance principles, guidelines, and processes necessary for success in today’s technology-dependent environment.

Doctors in these states are now eligible for CPC+. Experts share how to prepare.

Below are some perspectives on what these complaints mean for the parties’ chances and for consolidation in healthcare more generally.

Now a little more than halfway through 2016, it’s time to look at trends in the industry and how they will shape the relationships among stakeholders for the years to come.

As ACOs continue to grow in the healthcare sector, it is imperative that a liaison is in place to act as an intermediary between ACO members and patients to help achieve desired outcomes.

Risk adjustment has great potential if you follow these three simple rules.

As hospitals begin to search for key post-acute providers and implement new care pathways, providers should be aware of program waivers that afford greater flexibility in determining the most cost-effective care possible to ensure good outcomes for patients within the CJR model.