Category: Provider Network

Doctor's hands sorting through medical paperwork with decorative digital overlay.

AI in Medicare Advantage: How Health Care Executives Protect MLR and Network Integrity

BY TOG Network Solutions | May 05, 2026

What happens to your medical loss ratio when every Medicare Advantage recipient has an AI-powered assistant in their pocket? The era of information asymmetry is ending. As Becker's Payer Issues…

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Behavioral Health Strategy: Navigating the Financial Risk of Ghost Networks

BY TOG Network Solutions | Apr 01, 2026

April is recognized as both Counseling Awareness Month and Stress Awareness Month. While these observances provide a clinical focus on mental wellness, they also present a critical strategic window for…

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Four doctors sitting around a table having a thoughtful discussion.

Navigating the Payer Landscape: Strategic Insights from the J.P. Morgan Business Leaders Outlook

BY TOG Network Solutions | Mar 24, 2026

The sentiment among health care executives is shifting from reactive uncertainty to proactive, data-driven planning. This mirrors broader national trends identified in the J.P. Morgan 2026 Business Leaders Outlook, which…

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Young female doctor wearing a white coat helps an elderly female patient with her walker.

Navigating the Managed Medicaid Margin Crisis

For years, managed Medicaid was a reliable engine of growth and profitability for the nation’s largest health care insurers. However, a significant shift in the landscape has transformed the segment…

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Patient holds paper cutouts of kidneys indicating their location in the abdominal area.

Managing the High-Cost Burden of Chronic Renal Care

Managing the High-Cost Burden of Chronic Renal Care March is recognized as National Kidney Month, with World Kidney Day observed on March 13. While these observances focus on clinical awareness…

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Business man pouring over charts and working on a calculator.

Managing Margin Pressure: CMS Proposes Nearly Flat 2027 Medicare Advantage Rates

The Centers for Medicare and Medicaid Services (CMS) has released the 2027 Advance Notice for Medicare Advantage and Part D, proposing a base rate increase of 0.16%. While CMS projects…

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