Business Strategy

Payers and providers have traditionally operated on opposite sides of the tracks with limited collaboration, resulting in a disjointed and complicated experience for patients when accessing care.

Mercy Accountable Care Organization (ACO) has identified and successfully leveraged a critical factor to supplement its population health strategies.

Industry watchers weigh in following Covered California’s Peter Lee’s public bashing of UnitedHealth over the federal exchanges.

One month into 2016, it’s clear that this will be a year of massive change for the managed care industry. Here are seven predictions for some of the key issues that will emerge, intensify, or be resolved by the end of this year.

Nearly 60% of new MA plans are sponsored by providers, according to new Avalere analysis.

N.Y. Gov. Andrew Cuomo proposes a budget provision that would call for capping prices on some drugs and requiring drug companies to provide information about their costs.

New technology is changing how payers, providers, and patients interact. Stay ahead of the curve by monitoring these technology changes.

A common question facing healthcare executives is how to get started with population health management. Here are steps and strategies critical to success.

In this commentary, an industry insider shares his 2016 predictions for healthcare. Do you agree?

For decades, administrative costs for health plans have stalled. Today’s healthcare market is full of opportunities to trim the fat.

The precision medicine uptake is not as fast as predicted in healthcare organizations, but academic medical centers are jumping on board faster than others.

A new survey reveals what employers' medical plans are doing to rein in specialty drug cost and utilization.

We asked the Managed Healthcare Executive editorial advisory board to predict the biggest challenge healthcare executives will face this year. Here's what they said.

As the healthcare industry changes, health plan executives must master new skills.

New research: Hospitals risk millions from failure to provide consumer-friendly mobile apps. How to achieve exceptional consumer experience.

Broader exchange of ideas for diabetes health management and related programs may result in more efficient community-based programs with a wider impact.

Independence reaches a deal with NantHealth to cover next-generation whole genome sequences for a variety of cancers.

New initiative poised to be a model for health plan providers to foster improved collaboration between pharmacists and physicians.

Don't let your healthcare organization's information be compromised. Watch out for these common mistakes.

Innovation will be necessary to compete for consumers in the new market environment. Using data effectively can help plans stand out.

The Commonwealth Fund examined the effects of the ACA’s Medicaid expansion on low income adults in three states that took different approaches to the law. Here’s what they found.

While forming risk-based entities among Medicaid providers could be an effective way to better manage the care of low-income populations, the risk of unintended consequences cannot be ignored. A key hedge against these consequences is better use of patient data.

After much angst and several delays, the healthcare industry recently completed the ICD-10 transition, but was it really necessary?

Coordination is key in improving adherence and outcomes in patients with chronic conditions. Here’s how.

Change is in the air as a new year begins. These five trends will continue to gain momentum in the healthcare industry.

The changing healthcare industry is leading organizations to prioritize new skill sets during recruitment efforts.

Tips to help healthcare executives present their most authentic selves during remote interviews.

The solution to succeeding in value-based reimbursement models is to start inside the hospital with high acuity patients and build the systems that support them.

Survey reveals how size impacts health plan challenges, priorities, outlook, and technology use.

Survey reveals how size impacts hospitals' challenges, priorities, outlook, and technology use.