Business Strategy

The combination of unsustainable healthcare spending and the rapid growth of value-based reimbursement revenue models is driving the shift to patient-centered care across the continuum-or continuum-centered care.

Healthcare organizations are looking for new ways to engage consumers, streamline information sharing and transparency and collaborate with other industry stakeholders. As a result, healthcare stakeholders need to focus on three key strategies.

How approaching the open-enrollment process with a customer-centric mindset promotes member retention.

A recent survey reveals how generational differences affect consumers’ health plan and provider preferences and selections.

Creating a national data policy framework for empowered consumer choices.

With new requirements from CMS on the horizon, how will the shift to value-based care impact consumers, payers, and providers?

As pharmaceutical companies of all sizes continue to adapt to the ongoing internal and external pressures of the new health economy, it remains imperative that strategy maintain distinct capabilities to position the company ahead of its competitors.

Insights from the 2016 edition of the largest gathering in specialty pharmacy.

MACRA, which will further the shift to value-based reimbursement, has industry insiders grappling with the complexities, particularly those related to reporting guidelines for providers.

An expansion of the ACA requires health plans to cover a new preventive service: Regular nutritional counseling for millions of overweight Americans with other health risks.

Health insurance coverage remains a huge challenge for small businesses due to cost. Health plan providers and brokers are in a unique position to address these challenges and target the working uninsured with affordable options for coverage.

Colorado could have the first statewide universal healthcare system in the country if proposed legislation passes in November. Will it happen? Experts weigh in.

Insight from Paul Markovich, CEO, Blue Shield of California

Doug Chaet, senior vice president, Provider Networks and Value-Based Solutions at Independence Blue Cross, shares five strategies that can help providers succeed in value-based reimbursement models.

Democratic presidential candidate Hillary Clinton vows to provide more affordable, cost effective, accessible, and higher quality healthcare and insurance coverage. Here’s a closer look at seven key ways Clinton would change the healthcare system if elected president.

Hospitalizations represent up to 80 percent of the direct medical costs of heart failure; reducing heart failure hospitalizations can help bring down overall healthcare costs.

New regulations will check the drive to narrow networks, just as the business case for forming them grows more compelling.

Democratic presidential candidates Bernie Sanders and Hillary Clinton both vow to make healthcare more affordable, accessible, and higher quality. Here’s a closer look at two of the ways Sanders proposes to do this.

The Leapfrog Group announced its Hospital Safety Scores, which gives hospitals a grade of “A” through “F” for patient safety.

After suffering significant losses on the health insurance exchanges in 2015, insurance giants UnitedHealth Group and Aetna announced they may leave the exchanges next year.

A report from the Department of Health and Human Services indicates positive momentum in efforts to combat hospital-acquired conditions, but experts say more can be done.

A glimpse into the present and future of healthcare industry mergers and acquisitions

New analysis finds proposed Medicare payment changes for physician-administered drugs would reduce reimbursement for those that cost more than $480 per day in 2016. Seven of the 10 drugs that constitute the largest reduction in reimbursement are used to treat cancer.

Two presenters at the AMCP 2016 conference examine a Blue Cross and Blue Shield of Michigan pilot project to leverage technology for its medical specialty drug management program. Here are the lessons learned.

AMCP 2016 conference presenters from MedImpact outline their High-Cost Generic program that moves members to less-expensive, clinically relevant drug alternatives.