TOG Blog

Elder female patient wearing a plaid shawl and a cream turtleneck holds a white prescription bottle while receiving a comforting hand on her left shoulder from a young female health care worker wearing blue scrubs.

What Payers Need to Know About the Future of Provider Networks

Where members receive care is changing, and health insurance payers may need to rethink how their provider networks are designed to keep pace. As more services move beyond traditional hospital…

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Digital screen with a man's hand touching the letters AI that are surrounded by digital icons indicating a network.

AI ROI and Provider Network Contracting: What Payers Should Measure

Artificial intelligence is rapidly moving from experimentation to enterprise investment across the health care industry. The next challenge for executives is proving that those investments are actually creating value. That…

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Female doctor with shoulder length curly brown hair wearing a white lab coat sits at table with female patient to review prescription instructions.

Health Literacy Month: Why Provider Network Contracting Must Make Care Easier to Navigate

October is Health Literacy Month, an observance focused on making health information easier for people to understand and use. For health insurance payers, however, health literacy reaches well beyond the…

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Health care professional writing beside a laptop and stethoscope, with digital document and lock icons representing secure medical records and data.

Most-Favored-Nation Drug Pricing: What Medicaid Payers Need to Know

Prescription drug costs remain one of the most difficult expenses for Medicaid payers to forecast and manage. As federal policymakers explore most-favored-nation drug pricing, health plan executives need to understand…

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Health care professional writing beside a laptop and stethoscope, with digital document and security icons overlaid to represent secure medical records.

Medical Loss Ratio Rebates: What $759 Million Means for Payers

Health insurers are expected to return approximately $759 million in medical loss ratio rebates to individuals and employers in 2026. For payers, the number represents more than a regulatory obligation.…

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Health care professional using a calculator while reviewing documents, with a tablet and laptop on a desk.

Healthy Aging Month: Why Provider Network Contracting Matters for Payers

September is Healthy Aging Month, an annual observance that encourages adults age 45 and older to take a more active role in their physical, mental, social, and financial well-being. For…

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