Business Strategy

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To put more risk-based dollars in the bank, payers need to master a new level of gathering and reporting on not just claims data, but clinical data as well.

Brad Fluegel, chief healthcare commercial market development officer at Walgreens, discusses what managed care organizations and healthcare executives can learn from the success of retail clinics.

The Comprehensive Care for Joint Replacement (CCJR), has organizations’ leadership wondering how they will be able to perform in such a model. Here are some tips.

How plans can achieve the right balance between cost and outcomes

Traveling to Orlando for AMCP Nexus 2015? Make the most out of your trip by attending these presentations. View the top 10.

A new study by National Center for Policy Analysis (NCPA) finds that generic drugs are the best bargain in the healthcare system-but that may change if recent price hikes continue.

The National Health Council recently released a state progress report of health insurance exchanges. View the key findings.

Quality, financial performance provides glimpse at long-term effects

CMS recently released a proposed draft of its Medicare Reporting Requirements document for 2016 and, for the first time, the guidance includes reporting requirements for Medicare rewards and incentive programs. The new reporting requirement is slated to begin January 1. Are you ready?

Coming to a decision to outsource business processes is one thing. Deciding which services to outsource is another.

More plans look to outsourcing to increase productivity, lower costs

Health policy experts generally agree that properly tailored transparency tools can help to hold down prices. What is not settled at this point is what transparency should look like.

Most managed care executives believe they will recoup their investments in population health management (PHM) within four years, but many don’t have a clear vision of the pathway to success

Most payers and employers now offer high-deductible health plans (HDHPs), but questions remain regarding whether these options will actually help plans save on healthcare costs.

Questions remain regarding how those plans will impact hospital revenue.

If a crisis were to suddenly arise for your organization, would your people be ready to handle it?

While the introduction of the Health Insurance Marketplace plans in 2014 has accelerated the trend of more Americans with HDHPs, the number of such plans was already increasing before then.

A deeper dive into the proposed payer mergers reveals how they could impact market dynamics.

Christopher Kerns, MBA, managing director, Research and Insights, The Advisory Board Company, believes high-deductible health plans (HDHPs) will help foster high-value healthcare.

Here are seven tips healthcare leaders must keep in mind when speaking to the press.

Beyond the obvious training and work flow challenges associated with the ICD-10 transition, a whole host of challenges will arise as ICD-10 becomes the new reality.

A recent study projects that U.S. employers may see minimal savings to overall healthcare costs resulting from the introduction of biosimilars to the U.S. market.

While Affordable Care Act has created huge opportunities for payers, most of those opportunities cannot be leveraged to their full advantage using 20th century strategies.

Next time you are looking to hire a new executive assistant, find someone with these skills and attributes

Marketing experts stress that payers and providers must find new ways to communicate with these young patients. Here's how.