Business Strategy

Is the republican alternative ACA plan a viable trade-off? Here are some key elements of the plan to consider.

As health systems and physician groups marshal resources to launch their own plans, they must consider whether they have the necessary building blocks to successfully make the leap, how integrated a model they will pursue and whether they will build, buy or partner strategy.

What impact will MACRA have on your organization? We asked experts to tell us.

A new PwC Health Research Institute report notes that while strides are being made in population health, many organizations struggle to scale efforts.

The first-year results of the ACA’s Risk Adjustment Program are in. Find out how it worked out and what insurers need to do next.

Boosting patient engagement is critical as the industry shifts toward value-based payments. For payers and providers, higher engagement increases the likelihood of positive outcomes at lower costs.

Healthcare organizations must have sound IT project management practices in place to sensibly manage both human and financial resources. Here are nine best practices to follow.

There are more than 165,000 health- and wellness-related apps for iOS, but overall engagement remains low outside the top 10. To best benefit users, who should be responsible for health and wellness apps-employers, healthcare insurers or individual consumers? It depends.

Integrating IoT devices within healthcare systems allows professionals and individuals to have access to new health-related data used for informed, personalized healthcare applications and situations.

How much does diabetes cost the healthcare system and what's driving cost increases? Find out.

Here’s how remote monitoring works to improve diabetic patient care, and a look at whether payers are paying for it.

There are four key components at the root of the changing dynamic between payers and providers. Here’s what they are, and what to do about them.

The ER Savings Initiative is designed to deliver care in a hybrid model that collaborates with health systems to eliminate the unnecessary use and costs of their ERs.

Sterling Partners’ Dan Hosler identifies the subsectors for healthcare investing that can help reduce costs and improve quality.

In 2013, its first year taking part in CMS’ Shared Savings Accountable Care Organization (ACO) Program, Rio Grande Valley Health Providers saved nearly $12 million. Here, the CEO and CMO discusses the keys to success.

HHS has announced steps aimed at limiting short-term health plans and strengthening the marketplaces. Here's how you will be affected.

The goal of CMS’ proposal is to reduce costs while rewarding better outcomes for patients. Here are five things healthcare executives need to know.

The transition to value-based payment has accelerated rapidly over the past two years, and payers and providers predict even more dramatic changes.

Making these three changes to health insurance exchange plan offerings could attract more consumers and increase the likelihood of success.

Physicians need to be well-versed in the evolving government requirements for billing, reimbursement and overall healthcare delivery/patient experience. One expert outlines these important items for physicians to watch.

Humana's Bold Goal progress report aims to improve population health by addressing health barriers, increasing access to healthcare, encouraging healthy behaviors, and promoting the prevention and management of chronic conditions prevention and management.

Most patients hear the word “carcinoma” or “cancer” and believe they may die if they do not seek treatment. But ASCO researchers say that may be a problematic mentality.

Biosimilars will have a significant impact on cancer treatment, with the potential to drive cost savings, but will patients and providers be accepting?

Health plans and healthcare organizations are increasingly facing threats from cyber criminals. Here's how to better protect your organization.

Targeted treatments of HER2-positive breast cancers have dramatically prolonged many patients’ lives. But treatment outcomes in clinical trial settings don’t always translate into comparable real-world clinical value.

A look at how burnout affects providers, their patients, and the centers that employ them.

Expanded access or “compassionate use” programs allow patients to use investigational treatments, medical devices, or tests, before they have received FDA approval.

Determining what to measure, and how best to measure it, can be surprisingly complex-and appropriate metrics can vary between cancer types and patient populations.

The hurdle for managed care organizations is not identifying individuals who may benefit from support, rather, it’s finding a way to tailor efforts to engage members in the solutions being offered.

A discussion with Thomas H. Lee, MD, chief medical officer, Press Ganey