Are better-than-expected medical loss ratios in 2020 setting up payers to take a severe hit on profit margins in 2021? Go on offense by making moves that feature these 4 risk-mitigating hallmarks. Six months into the novel coronavirus pandemic in the U.S., the crisis...
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COVID-19
“The Great Pause” Brings Unyielding Uncertainty to Medical Loss Ratios but Also Opportunity
Health Plans Launch Innovative Solutions to Respond to Mental Health Crisis
Transparent data sharing supports seamless care coordination, relevant outreach that mitigates effects of chronic conditions. The novel coronavirus pandemic continues its near-perfect record as a harsh but effective teacher for the healthcare industry as it...
Healthcare Interoperability Poised to Solve COVID-19’s Big Data Crisis
Coronavirus highlights power of big data and the need for interoperability to improve population health. How can health plans lead the way? What’s the single biggest weapon used by government, pharma, academic researchers, healthcare systems, and health insurers alike...
From Volume to Value: Alternative Payment Models Win During a Healthcare Crisis
As patient volumes drop due to the COVID-19 pandemic, fee-for-service payment models hurt providers. Is this finally the time for value-based care? COVID-19 is decimating provider finances. Hospitals are losing over $40 billion per month in lost revenue due to...
Coronavirus New Normal: What does it mean for health plan members?
25 million Americans projected to lose employer-sponsored healthcare coverage due to the COVID-19 recession. How will this disruption affect the relationship between health plans and consumers? As of the end of April 2020, about 30 million people in the U.S. are newly...
Coronavirus Boosts Telehealth Adoption
The COVID-19 pandemic prompts payers to encourage the shift to telehealth, a move supported by patients and providers. How will this change the future of healthcare delivery? The novel coronavirus stopped traditional healthcare in its tracks, but there’s one bright...
Coronavirus Crushes Providers. Health Plans to the Rescue!
To support healthcare providers financially impacted by COVID-19, health plans rush to provide funds, ease administrative burden with prepay and engagement initiatives. Right now, the healthcare industry is in the thick of the novel coronavirus pandemic, with...
Your health plan’s best crisis response strategy? Innovation.
Health plans set themselves up for success – during a pandemic and beyond – by pursuing advanced technology to engage providers, satisfy members, and improve population health initiatives. The healthcare system is on the front lines of the novel Coronavirus pandemic,...
Do You Have a Healthcare Fraud Prevention Strategy Ready for COVID-19?
Artificial Intelligence allows health plans to more nimbly address FWA while reducing false positives To make an obvious understatement, the new coronavirus (COVID-19) pandemic is an event like we’ve never seen. While essentially the whole country is shut down, the...