A high-performing provider network is essential for a successful health plan. It can help you attract and retain members, improve quality outcomes, reduce costs, and bolster financial performance. However, moving to a more productive provider network can be a complex...
Many companies (including but not limited to health care organizations) experienced the negative effects of supply chain shortages during the COVID-19 pandemic. However, there are other reasons for such supply issues. The most recent shortage has impacted many...
Most people who have health insurance are at least somewhat familiar with the term 'out-of-network.' Those who work in the health insurance industry likely explain this concept to members often. While many people know that out-of-network refers to providers and...
Medicaid rate changes continue to impact health care providers in all practice areas. But many people don’t know that most legislators agree a rate increase is key to the continuation of many essential medical services. Rather, the root of the problem is the debate...
Just over 13 years after it was first enacted, the Affordable Care Act (ACA) seems to be experiencing major infrastructure issues. Unlike some systems issues of the same nature, this appears to be due to the overwhelming demand for ACA-based health insurance plans....
Price transparency has been a hot topic over the past few years. It all began with the Hospital Price Transparency Rule, which was passed in 2020 just as the COVID-19 pandemic began to complicate the health care industry. This legislation went into effect in 2021,...
Nearly 88% of people looking for health insurance value personalization in their plans as much or more than they did one year ago. It’s no surprise that this number has skyrocketed, since the COVID-19 pandemic magnified problems many members had with their health...
With a combination of medical jargon, abbreviations, and acronyms, it’s all too common for patients to be left in the dark about their health care treatment. That’s why the term ‘alphabet soup’ is often used to describe professional titles in the field of medicine. If...
In response to the growing number of senior citizens in the U.S., Humana has begun creating primary care centers with integrated care teams. Such centers have been designed to better address older adults’ social needs in tandem with complex medical conditions. The...
Recent research has shown that a lifestyle-based treatment program targeting brain health reduced dementia risk by 30%. The results of this 2-year program were compared to those yielded from standard provider recommendations, including generic guidance such as eating...