Health Care Payer Strategy

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How to help next-gen payer operations succeed McKinsey

(2 days ago) WEBIn a survey of payer executives conducted in August 2020, 2 McKinsey’s survey of 50 payer executives was conducted online in August 2020 and included executives from health plans of all sizes and lines of business. Respondents held …

https://www.mckinsey.com/industries/healthcare/our-insights/next-generation-payer-operations-how-to-prioritize-for-success

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2024 Payer Strategies: Population-Based Plans, MA Differentiation

(4 days ago) WEBIn 2024, payer strategies will include improving health equity partnerships, differentiating their Medicare Advantage plans, and offering care navigation. January 02, 2024 - The …

https://healthpayerintelligence.com/news/2024-payer-strategies-population-based-plans-ma-differentiation

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Operational Maturity for US Health Care Payers BCG

(4 days ago) WEBFour archetypes of operational maturity facilitate the development of a customized program. Payers that master the challenges will promote their …

https://www.bcg.com/publications/2023/operational-maturity-for-us-health-care-payers

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Health Care Payers COVID-19 Impact Assessment: Lessons …

(3 days ago) WEBThe Payer Response to COVID-19. The COVID-19 pandemic imposed a sudden and significant shock to America’s fragmented health care system. While the volatility of …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406497/

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A Post-Merger Integration Agenda for Health Care Payers BCG

(7 days ago) WEBThe ongoing evolution and consolidation of the health care sector have fueled payer M&A. As in many industries, the rapid adoption of digital technology means …

https://www.bcg.com/publications/2021/health-care-payers-pmi-agenda

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8 healthcare trends for 2024: A guide for health system leaders …

(8 days ago) WEBBoards can exert pressure on MA plans to ensure patients’ health needs are met and their health systems are fairly recognized and compensated. Boards should …

https://www.hfma.org/finance-and-business-strategy/healthcare-business-trends/8-healthcare-trends-for-2024-a-guide-for-health-system-leaders-and-their-boards/

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Healthcare Payers - Health Insurance Consulting Bain …

(9 days ago) WEBOur healthcare payers consulting teams collaborate with you to address: Value chain re-alignment triggered by M&A. Renewed competition for core processes, from providers and privately funded third parties. Increased …

https://www.bain.com/industry-expertise/healthcare/healthcare-payers/

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11 Payment and Payer-Based Strategies The …

(5 days ago) WEB• A single provider (e.g., a “medical home”) could accept the comprehensive care payment and make payments from it to other providers who deliver care during the time period covered, or the comprehensive care …

https://nap.nationalacademies.org/read/12750/chapter/15

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Payment and Payer-Based Strategies - The Healthcare Imperative

(4 days ago) WEBTo obtain better value for investments made in health care, significant discussion has emerged on how best to align economic and health incentives to achieve these goals …

https://www.ncbi.nlm.nih.gov/books/NBK53906/

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Healthcare Analytics for Payers: A Roadmap

(5 days ago) WEBA Healthcare Payer Analytics Strategy: Build a Roadmap to Manage Risk. A roadmap will help the payer navigate their own way through a minefield of potential risks …

https://www.healthcatalyst.com/insights/healthcare-analytics-payers-roadmap

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Supporting Complex Care Models through Strong Provider-Payer

(4 days ago) WEBUnder AIM, each participating health care provider organization partnered with a health care payer – a health plan associated with the provider health system or …

https://www.chcs.org/supporting-complex-care-models-through-strong-provider-payer-partnerships-key-considerations/

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How providers can optimize payer contract negotiations HFMA

(5 days ago) WEBThe following steps can help ensure a provider’s contract negotiating team will achieve a favorable contract. 1 Start negotiating one year in advance. The provider …

https://www.hfma.org/payment-reimbursement-and-managed-care/how-providers-can-optimize-payer-contract-negotiations/

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EY Health Pulse Survey: Digital Health Solutions Boost Efficiencies …

(7 days ago) WEBErnst & Young LLP (EY US) announced today the release of its inaugural Health Pulse Survey, which polled over 100 payer and provider health care executives …

https://www.ey.com/en_us/newsroom/2024/02/ey-health-pulse-survey-digital-health-solutions-boost-efficiencies-and-automation-but-roi-has-yet-to-come

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Aveanna Makes Progress On Strategic Transformation, Preferred …

(6 days ago) WEBAveanna’s payer strategy will be critical throughout the remainder of 2024, partly due to the fact the company’s payer mix is skewed heavily toward government …

https://homehealthcarenews.com/2024/03/aveanna-makes-progress-on-strategic-transformation-preferred-payers-strategy/

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Ten Things to Know About Consolidation in Health Care Provider …

(6 days ago) WEBNational health spending totaled $4.5 trillion in 2022—17% of gross domestic product (GDP)—and is projected to grow faster than GDP through 2031, …

https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/

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2020 Democrats on Health Care - The New York Times

(9 days ago) WEBThe Context. Single-payer health care is a dividing line in the race, separating Democrats who want to replace the private insurance system from those who …

https://www.nytimes.com/interactive/2019/us/politics/obamacare-democratic-candidates.html

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UnitedHealth Group Updates on Change Healthcare Cyberattack

(8 days ago) WEBChange Healthcare Service Restoration. Change Healthcare has made continued strong progress restoring services impacted by the event. We have prioritized …

https://www.unitedhealthgroup.com/newsroom/2024/2024-04-22-uhg-updates-on-change-healthcare-cyberattack.html

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Exploring What An Amedisys Divestment Strategy Could Look Like

(2 days ago) WEBOne possibility could be examining payer mix or a market’s Medicare Advantage (MA) penetration as part of a divestment strategy. Despite most Medicare …

https://homehealthcarenews.com/2024/04/exploring-what-an-amedisys-divestment-strategy-could-look-like/

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California talks universal health care … again - POLITICO

(4 days ago) WEBEstablishing single-payer health care in the state has been a hard sell in the past, mainly because of the expensive price tag. Legislative analysts have estimated it …

https://www.politico.com/newsletters/california-playbook-pm/2024/04/23/california-talks-universal-health-care-again-00153962

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Advances Community Health CEO sets vision for improved health …

(7 days ago) WEBJoining a health care organization amid a global pandemic isn’t easy, but that was the reality when Scot McCray joined Advance Community Health in 2020. Advance, …

https://www.bizjournals.com/triangle/news/2024/04/25/scot-mccray-ceo-advance-community-health-strategy.html

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HCA Healthcare (HCA) Q1 2024 Earnings Call Transcript

(9 days ago) WEBHCA Healthcare (HCA-2.37%) Q1 2024 Earnings Call Apr 26, 2024, improved payer mix and solid operating margins. As we look to the rest of the year, we …

https://www.fool.com/earnings/call-transcripts/2024/04/26/hca-healthcare-hca-q1-2024-earnings-call-transcrip/

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HCA Healthcare Reports First Quarter 2024 Results

(Just Now) WEBHCA Healthcare, Inc. (NYSE: HCA) today announced financial and operating results for the first quarter ended March 31, 2024. Key first quarter metrics (all …

https://investor.hcahealthcare.com/news/news-details/2024/HCA-Healthcare-Reports-First-Quarter-2024-Results/default.aspx

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Horizon NJ Health QUICK REFERENCE GUIDE

(7 days ago) WEBa conditional acceptance report is generated and sent to the hospital or health care professional immediately. After this acceptance, status of claims, adjusted claims, and …

https://www.horizonnjhealth.com/sites/default/files/Quick_Reference_Guide.pdf

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Opinion: California's Single-Payer Health Insurance Dream …

(7 days ago) WEBThen there’s the devastating impact single payer would have on patients. One need only look to Canada and the United Kingdom to see what government-dominated …

https://timesofsandiego.com/opinion/2024/04/25/californias-single-payer-health-insurance-fantasy-is-turning-to-ashes/

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AHA podcast: Hannibal Regional Healthcare System shares unique

(4 days ago) WEBRecruiting a young and engaged workforce is particularly challenging for rural care providers. Susan Wathen, vice president of human resources at Hannibal Regional …

https://www.aha.org/news/headline/2024-04-26-aha-podcast-hannibal-regional-healthcare-system-shares-unique-strategies-recruiting-next-generation

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2025 AHA Rural Health Care Leadership Conference AHA

(5 days ago) WEBThe 2025 AHA Rural Health Care Leadership Conference, February 23-26 in San Antonio, will gather more than 1,000 rural health leaders committed to advancing …

https://www.aha.org/education-events/2025-aha-rural-health-care-leadership-conference

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Payer ID Payer Name Comments - ABILITY Network

(2 days ago) WEB11103 Beacon Health Strategies (Web Credentials Required) Enrollment Required 13406 Beneit Management Inc. 11128 Better Health Plans (Unison Health …

https://www.abilitynetwork.com/wp-content/uploads/2019/11/November_EligibilityPayer_List.pdf

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5 Strategies for Improving Mental Health at Work - Harvard …

(2 days ago) WEBSummary. Companies are investing in — and talking about — mental health more often these days. But employees aren’t reporting a corresponding rise in well-being.

https://hbr.org/2024/04/5-strategies-for-improving-mental-health-at-work

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Payer ID Payer Name Comments - ABILITY Network

(2 days ago) WEB11103 Beacon Health Strategies (Web Credentials Required) Enrollment Required 13406 Benefit Management Inc. 11128 Better Health Plans (Unison Health …

https://www.abilitynetwork.com/wp-content/uploads/2019/12/December_EligibilityPayer_List.pdf

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