Industry Analysis

Findings from industry studies show major cost savings for beneficiaries in Medicare Advantage plans. Some say the cost per enrollee for the government is higher than that for traditional Medicare.

In this week's episode of "Tuning In to the C-Suite" podcast, Managed Healthcare Executive Senior Editor, Peter Wehrwein and Associate Editor, Briana Contreras, spoke with yet another Editorial Advisory Board Member for a segment of the "Meet the Board" series. The two had the pleasure of chatting with Meg Murray, M.P.A., founding CEO of the Association for Community Affiliated Plans, about her journey in healthcare, her organization and were able to look into some of her views about the ACA, equity and racism in healthcare and the Biden Administration’s effects on healthcare.

Glaucoma affects many people across the globe, but primarily, it's affecting African Americans due to access.

Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Mark Poling, chief product officer of Zipari, a health insurance tech organization, about how a direct-to-consumer model can simplify the enrollment process. He also shared the benefits the model has to health insurance systems’ operations.

Predictions that the company would make a major move to dominate American healthcare have not come to pass. So far.

In this week’s episode of Tuning In to the C-Suite podcast, MHE Associate Editor Briana Contreras spoke with Ash Shehata, KPMG’s national sector leader for healthcare & life sciences. The two chatted about a recent paper by KPMG titled “From payor to healthcare partner,” which highlights how the pandemic drove changes for plans to adopt a patient-centric model and it gives a look into the six healthcare trends to watch for in 2021.

In the four months between February and May, roughly 5.4 American workers lost their coverage.

Managed Healthcare Executive's Senior Editor, Peter Wehrwein, and Associate Editor, Briana Contreras, spoke with MHE Editorial Advisory Board Member Lili Brillstein for a new episode of the "Meet the Board" series on "Tuning In to the C-Suite" podcast. Lili is CEO of BCollaborative, which works with stakeholders across the healthcare continuum to successfully make the move from fee for service to value-based healthcare. In this episode we get to learn a bit more about Lili's career and hear her thoughts on the advancements of episodes of care, as well as the challenges of transitioning from fee-for-service to value-based care during COVID-19.

Two of the biggest issues in healthcare, currently, are the lack of communication between prescribers and pharmacists, and the number of factors that prevent healthcare professionals from offering patient-centric services.

Providers are moving toward acceptance; the rules are here to stay. Payers recognize that people need to know prices.

Smaller providers that have seen sharp declines in revenue may be acquisition targets for large healthcare systems.

There’s no going back to the ways of working before COVID-19’s arrival, say many in the industry. Insurers and PBMs are reducing their footprint as work becomes part remote, part in person.

Insurers are taking a hands-on approach to primary care, buying or partnering with practices or setting up their services.

The number of participants in the Medicare Shared Savings Program has tapered off, and the Direct Contracting Model may put accountable care organizations at a disadvantage. The National Association of ACOs wants the Biden CMS to make some changes.

In this second part of a three-part series, Steven D. Pearson, M.D., M.Sc., founder and president of ICER addresses if pricing of PCSK9 inhibitors put ICER on the map.

A couple of years ago, there was a lot of chatter about the Amazonifcation of healthcare. Well, that hasn’t happened. But the company is breaking into a sector of the economy that accounts for almost 18% of the American gross domestic product. Perhaps healthcare’s journey of Amazonifcation has started but is going step by step.

Today's episode of Tuning In to the C-Suite shares a conversation between Associate Editor of MHE, Briana Contreras, and CEO of Ob Hospitalist Group, Lenny Castiglione. The two talked about how and why hospitals and health systems are increasingly working with third party providers for obstetrics, as well as anesthesiology, nursing, and others to reduce costs and improve care for patients.

In this first video of a two-part video series, MHE spoke with Dr. Ami Parekh, chief medical officer of Grand Rounds. Ami discussed the rise of the chief medical officer role, how businesses can benefit from it and what it means for the future of the C-suite. She also explained why it is so essential for businesses to provide advice and clinical guidance to help best keep operations running safely.

In this first of three-part video interview series, MHE spoke with founder and CEO of Gray Matter Analytics. In the discussion, Sheila addressed the topic of how healthcare organizations are missing out by not actively expanding their efforts to seek out and fast track talented individuals across many minority populations, especially in the c-suite.

In this final video of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

In this second of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

In this first of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

In this month's episode of the Meet the Board podcast series, MHE spoke with Signify Health's Senior Vice President of Episodes of Care, François de Brantes. In the discussion de Brantes touched on a few facts about himself, he shared the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

Analysis also shows higher proportion of low- and modest-income beneficiaries in Medicare Advantage than Traditional Medicare.

In this final part of a two-part video series, Senior Editor Peter Wehrwein spoke with Vayong Moua, the Director of Racial and Health Equity Advocacy for Blue Cross and Blue Shield of Minnesota (BCBSMN), about healthcare equity issues, how they relate to access issues, the political determinants of health and killing of George Floyd.