Industry Analysis

Data analytics allows providers to gain insights from performance management measures and metrics that hold the clues to financial viability under risk-based and pay-for-performance contracts. By embracing advanced analytics, hospitals and health systems can accelerate their path to value.

Results from a survey conducted by DirectPath revealed many consumers still lack the knowledge required to make informed choices about their health plan and care, which displays as a concern for healthcare education and transparency.

Demand for mental health care is booming. With a shortage of psychiatrists, author of this opinion piece, Robert Krayn, asks how can we ensure providers are empowered to deliver the best care possible for their patients?

But CVS, Walgreens and Walmart differ in how they are setting up in-store health clinics.

Medicare funding shortfalls may trickle down to the Medicare Advantage plans and the Star Rating program bonuses, which have quadrupled in recent years.

U.S. hospitals are spending $310 million annually to manage the additional clinical, operational, logistical, and patient care work associated with white and brown bagging requirements, according to a new report.

Almost 95% of U.S. employers surveyed expect to see increased demand for medical services due to employees deferring care because of the pandemic. More than 90% are concerned about their employees’ long-term mental health because of COVID-19, according to a survey of 136 large employers by the Business Group on Health.

Pandemic accelerates adoption of automation in healthcare.

The first half of 2021 saw 372 deals averaging $39.6 million, which is already more than the total value of the deals done in all of 2020.

Artificial intelligence can help deal with everyday problems such as prior authorization and high utilization. But payers are also eyeing it for loftier purposes.

It's rate-setting season for insurers, although the full picture for 2022 premiums won’t emerge for some months yet.

The United States does not have a uniform health system and has no universal healthcare coverage. The health disadvantage of the U.S. relative to other high-income countries is health disparities in health services.

Oscar and Bright Health, with their retail orientation, are attracting investment, adding members, entering partnerships and making acquisitions.

Findings from industry studies show major cost savings for beneficiaries in Medicare Advantage plans. Some say the cost per enrollee for the government is higher than that for traditional Medicare.

Glaucoma affects many people across the globe, but primarily, it's affecting African Americans due to access.

Predictions that the company would make a major move to dominate American healthcare have not come to pass. So far.

In this week’s episode of Tuning In to the C-Suite podcast, MHE Associate Editor Briana Contreras spoke with Ash Shehata, KPMG’s national sector leader for healthcare & life sciences. The two chatted about a recent paper by KPMG titled “From payor to healthcare partner,” which highlights how the pandemic drove changes for plans to adopt a patient-centric model and it gives a look into the six healthcare trends to watch for in 2021.

In the four months between February and May, roughly 5.4 American workers lost their coverage.

Managed Healthcare Executive's Senior Editor, Peter Wehrwein, and Associate Editor, Briana Contreras, spoke with MHE Editorial Advisory Board Member Lili Brillstein for a new episode of the "Meet the Board" series on "Tuning In to the C-Suite" podcast. Lili is CEO of BCollaborative, which works with stakeholders across the healthcare continuum to successfully make the move from fee for service to value-based healthcare. In this episode we get to learn a bit more about Lili's career and hear her thoughts on the advancements of episodes of care, as well as the challenges of transitioning from fee-for-service to value-based care during COVID-19.

Two of the biggest issues in healthcare, currently, are the lack of communication between prescribers and pharmacists, and the number of factors that prevent healthcare professionals from offering patient-centric services.

Providers are moving toward acceptance; the rules are here to stay. Payers recognize that people need to know prices.

Smaller providers that have seen sharp declines in revenue may be acquisition targets for large healthcare systems.

There’s no going back to the ways of working before COVID-19’s arrival, say many in the industry. Insurers and PBMs are reducing their footprint as work becomes part remote, part in person.

Insurers are taking a hands-on approach to primary care, buying or partnering with practices or setting up their services.

The number of participants in the Medicare Shared Savings Program has tapered off, and the Direct Contracting Model may put accountable care organizations at a disadvantage. The National Association of ACOs wants the Biden CMS to make some changes.

A couple of years ago, there was a lot of chatter about the Amazonifcation of healthcare. Well, that hasn’t happened. But the company is breaking into a sector of the economy that accounts for almost 18% of the American gross domestic product. Perhaps healthcare’s journey of Amazonifcation has started but is going step by step.

Today's episode of Tuning In to the C-Suite shares a conversation between Associate Editor of MHE, Briana Contreras, and CEO of Ob Hospitalist Group, Lenny Castiglione. The two talked about how and why hospitals and health systems are increasingly working with third party providers for obstetrics, as well as anesthesiology, nursing, and others to reduce costs and improve care for patients.

In this final video of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

In this second of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

In this first of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.