Leadership

Patient expectations will push healthcare to evolve by 2030, according to 21 payer executives.  Leaders said AI, new models of care and a push toward convenience will transform healthcare in the next five years.  Becker’s connected with 21 leaders to…

When it comes to delivering health care, Medicaid health plans are committed to serving our most vulnerable members. However, funding cuts compromise our ability to provide quality care. Instead, we advocate for “smart spending” – increased investments into Medicaid that…

Providence Health Plan’s food-as-medicine program has “blazed a trail” in the space, according to Melissa Topp, MSN, RN, executive director for care management.  The program has led to 82% of participating members seeing an improvement in their food disparity score,…

As consumers seek convenient ways to manage their health, digital health solutions – also known as health and wellness apps – have seen a significant surge. These tools, which offer a variety of services, including support for weight loss and…

When it comes to benefits, employers often look for two things: new ways to keep up with rising healthcare costs and more flexibility in how they offer benefits.  To meet these expectations, Providence Health Plan is calibrating its offerings for…

Industry Challenge According to the recent Gartner report on “How Clinical Data Improves US Healthcare Payer Interoperability,” health plan leaders are counting on the integration of clinical data “locked in provider’s electronic health records” to enable a host of needed…

As the healthcare industry works to address rising costs and the challenge of consistent access to care for all, a recent study highlights the growing recognition from primary care doctors that value-based care models are essential for delivering high-quality, cost-effective care.…

Complacency is one thing holding back the growth of the individual coverage health reimbursement arrangement, or ICHRA, market, according to Janet Liang, president of insurance at Oscar Health.  Oscar Health has laid out plans to double its membership by 2027.…

Kindred Hospitals, a national network of long-term acute care hospitals (LTACHs), provide specialized treatment and rehabilitation for medically complex patients. LTACHs like Kindred are equipped to provide the same level of treatment as short-term acute care hospitals (STACHs) can but…

I. Introduction Payer-led care management serves as an important mechanism through which payers can exert influence on health outcomes, close care gaps, and enhance the performance metrics of health plans. It is progressively becoming more important in the rapidly evolving…