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Own vs. Rent: What is the Best Way to Establish a Viable Provider Network?
Insurance carriers are under significant pressure to cut costs while continuing to support the recent pandemic-related surge in Medicaid enrollment. These expectations may make insurance companies question whether it makes…
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COVID’s Impact on Children’s Behavioral Health
Children everywhere are feeling the unpredictable effects of COVID and the resulting societal change, including family insecurity, job loss, eviction, and domestic violence. This has led many kids to experience…
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Lower Health Care Costs by Addressing Social Determinants of Health
The Cost of a Healthy Life The American Hospital Association reports socioeconomic factors are responsible for approximately 40% of a patient’s health outcomes. Inequities in patient populations better known as…
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Is Your Provider Network Ready for Your RFP?
Last month, the Ohio Department of Medicaid (ODM) released a request for applications (RFA) to lead Ohio’s next-generation managed care program supporting more than 90% of Ohioans receiving health care…
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Maintaining a Healthy Provider Network: Resolve & Prevent Network Inadequacy Fines
The Texas Department of Insurance fined Humana $700,000 in 2018 for network inadequacies caused by an insufficient number of anesthesiologists in two counties. The loss of revenue combined with the…
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FQHCs: Add Them To Your Network Now
An estimated 40 million people have lost work, along with their health insurance, since the global pandemic appeared in the U.S. earlier this year. Many of these individuals will turn…
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