Business Strategy

An accurate account of your provider roster is essential to driving value-based care, according to one expert.

Greg Kennedy, research project manager with the ACO Research Team at the Dartmouth Institute for Healthcare Policy and Clinical Practice at Dartmouth College, shares recent ACO research findings.

Industry watchers weigh in on UnitedHealth Group’s announcement that it will exit all but a “handful” of state Affordable Care Act (ACA) exchanges.

At the AMCP Annual Meeting, three panelists shared real-world examples of technology that is improving patient engagement, adherence, and outcomes

At AMCP, four stakeholders representing the specialty pharmacy perspective, manufacturer perspective, payer perspective, and PBM perspective shared their thoughts on the future of specialty pharmacy.

At the AMCP16 conference, Managed Healthcare Executive invited some of the nation’s leading pharmacy and managed care experts to join us to discuss some of the most critical managed care pharmacy challenges facing the industry.

To achieve scale economies, large hospitals and healthcare systems should shift toward integrated organizations with standardized procedures and systematically reduced costs.

A new report from IMS Institute for Healthcare Informatics finds that biosimilar acceptance will grow and drive change in the healthcare system.

Covered California adopts significant new changes to its contracts with health insurers as part of an aim to take health care reform to the next level.

Comprehensive Primary Care Plus (CPC+) advanced primary care medical home model aims to strengthen primary care through a regionally-based multipayer payment reform and care delivery transformation.

A new study explores the tangible effects of the ACA and the study author weighs in on the implications for managed care.

Experts says UnitedHealthcare’s new boutique-style health plan is designed to drive innovation in primary care.

Following on the heels of UnitedHealthcare, Highmark weighs whether staying on the exchange marketplace will be viable.

Here are 10 solutions that come together to provide a multifaceted approach to medication adherence.

Medicare Advantage plans that are slow to submit risk adjustment data are at a big disadvantage.

Don’t let these common misconceptions stop you from this high-impact, low-cost way to engage with patients.

Here are some of the innovative approaches payers and providers are taking to quell the diabetes epidemic, and curb the costs associated with it.

As patients look to make more informed decisions about healthcare services, payers can leverage comparative analytics to deliver greater price transparency

There is so much data available at all levels of healthcare, and technology and public support is on the cusp of a breakthrough in using this information for widespread improvements.

Here are three questions payers must ask to determine providers’ readiness to engage in risk-based reimbursement.

Industry insiders believe that the Anthem lawsuit against Express Scripts over drug pricing may provide some clues into this complex situation.

… and solutions from experts

While value-based reimbursement presents opportunities for payers and providers, succeeding in such a reimbursement model can be challenging. Here are four things to strive for that could increase the likelihood of success in a value-based reimbursement model.

While the high cost of specialty pharmacy is no surprise in the healthcare industry, infusibles have additional challenges. Here are the challenges that top the list, and what to do about them.

In the move to value-based care, there have been surprises and disruptions for payers and providers alike. In this Q&A, an expert shares where we are now.