Business Strategy

AHIP’s president and CEO Marilyn Tavenner discusses the association’s top priorities, challenges, and opportunities.

Experts break down the controversy over the agency’s release of Overall Hospital Quality Star Ratings.

Are you tracking your prospective pharmacy partners to measure their potential impact on your Star Rating? You should be.

As the 2016 presidential election approaches, analysts and experts are advising healthcare executives to watch and monitor certain issues.

Health insurers and providers are looking for ways to grow outside of the United States. Here’s a look at some of the tactics that are picking up traction.

The Medicare Star Ratings program is one way regulators are trying to improve outcomes while reducing costs, but what is really at stake for health plans, and do consumers even care?

Given what will occur in California, what should executives be aware of? What does the future hold for exchanges nationwide? Experts weigh in.

To participate in Medicare and Medicaid, hospital and critical access hospitals (CAHs) would need to meet new criteria.

Michael Abrams of Numerof and Associates healthcare consulting firm discusses how the DOJ’s actions to block the Anthem-Cigna and Aetna-Humana mergers could affect the industry.

The government recently filed lawsuits to block Aetna-Humana and Anthem-Cigna mergers. Here’s how experts say this will impact the industry.

Several lawsuits have been filed by qualified health plans offering coverage on the Affordable Care Act health insurance exchanges.

A new “secret shopper” study shows that problems exist for patients with acute conditions accessing services for patients. Effectively addressing issues of network adequacy may require more accurate provider information.

The Managed Healthcare Executive editorial advisory board says healthcare executives should watch out for these seven leadership deficiencies.

President Obama recently reviewed the ACA. Find out what he said are the top successes, and how policy insiders are reacting.

A new survey from Willis Towers Watson has interesting findings related to how employers view exchange viability

Shifting patient demographics will create an ideal scenario for the online/mail-order pharmacy market in the next five to ten years.

The impacts of the ever-changing health care marketplace and how employers, brokers and carriers have adapted

Over the next decade, health spending is expected to grow at an average rate of 5.8% per year.

Find out what drives patients to international destinations for treatments and what these destinations provide.

As payers look for growth opportunities internationally, they should watch nother growing trend: medical tourism.

A new KFF issue brief finds that healthcare coverage problematic for some, even as coverage is gained through the ACA.

Karen B. DeSalvo, National Coordinator for Health Information Technology, gives the best courses of action for top technology challenges and opportunities facing healthcare executives.

A new Quest Diagnostics and Inovalon study cites barriers to value-based care, but offers advice on how to overcome them.

Express Scripts Exchange Pulse report found that utilization, particularly for traditional meds, was one of the biggest factors driving spending in 2015, accounting for more than half of the exchange plans $99 PMPY increase in spending between 2014 and 2015.

Health plans must find new and meaningful ways to connect with patients of diverse backgrounds.

Remote monitoring studies are missing the mark when assessing the value of the technology. Here’s why.

Is digital health integration the missing link in understanding chronic diseases and what should physicians be asking to ensure the data they want to receive is captured effectively?

Payers pair with providers to manage patients with chronic disease at a distance.

Many health systems have a hard time capturing and using data from patients that can make a real impact on their businesses. Here are some innovative projects to have on your radar.

In an era when adherence to specialty pharmaceuticals is disturbingly low, value-based pricing needs real-world results, not single-arm accelerated trials.