Business Strategy

Several lawsuits have been filed by qualified health plans offering coverage on the Affordable Care Act health insurance exchanges.

A new “secret shopper” study shows that problems exist for patients with acute conditions accessing services for patients. Effectively addressing issues of network adequacy may require more accurate provider information.

The Managed Healthcare Executive editorial advisory board says healthcare executives should watch out for these seven leadership deficiencies.

President Obama recently reviewed the ACA. Find out what he said are the top successes, and how policy insiders are reacting.

A new survey from Willis Towers Watson has interesting findings related to how employers view exchange viability

Shifting patient demographics will create an ideal scenario for the online/mail-order pharmacy market in the next five to ten years.

The impacts of the ever-changing health care marketplace and how employers, brokers and carriers have adapted

Over the next decade, health spending is expected to grow at an average rate of 5.8% per year.

Find out what drives patients to international destinations for treatments and what these destinations provide.

As payers look for growth opportunities internationally, they should watch nother growing trend: medical tourism.

A new KFF issue brief finds that healthcare coverage problematic for some, even as coverage is gained through the ACA.

Karen B. DeSalvo, National Coordinator for Health Information Technology, gives the best courses of action for top technology challenges and opportunities facing healthcare executives.

A new Quest Diagnostics and Inovalon study cites barriers to value-based care, but offers advice on how to overcome them.

Express Scripts Exchange Pulse report found that utilization, particularly for traditional meds, was one of the biggest factors driving spending in 2015, accounting for more than half of the exchange plans $99 PMPY increase in spending between 2014 and 2015.

Health plans must find new and meaningful ways to connect with patients of diverse backgrounds.

Remote monitoring studies are missing the mark when assessing the value of the technology. Here’s why.

Is digital health integration the missing link in understanding chronic diseases and what should physicians be asking to ensure the data they want to receive is captured effectively?

Payers pair with providers to manage patients with chronic disease at a distance.

Many health systems have a hard time capturing and using data from patients that can make a real impact on their businesses. Here are some innovative projects to have on your radar.

In an era when adherence to specialty pharmaceuticals is disturbingly low, value-based pricing needs real-world results, not single-arm accelerated trials.

Is the republican alternative ACA plan a viable trade-off? Here are some key elements of the plan to consider.

As health systems and physician groups marshal resources to launch their own plans, they must consider whether they have the necessary building blocks to successfully make the leap, how integrated a model they will pursue and whether they will build, buy or partner strategy.

What impact will MACRA have on your organization? We asked experts to tell us.

A new PwC Health Research Institute report notes that while strides are being made in population health, many organizations struggle to scale efforts.

The first-year results of the ACA’s Risk Adjustment Program are in. Find out how it worked out and what insurers need to do next.