The Unseen Impact: How Price-Fixing Lawsuits Are Reshaping Health Insurance Provider Networks
For health insurance executives focused on the bottom line, understanding the evolving landscape of provider networks is paramount. A significant development is unfolding in the courts that could redefine how…
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The Invisible Threat: Understanding and Overcoming Ghost Networks
The integrity of your provider network is fundamental to member satisfaction, regulatory compliance, and ultimately, your bottom line. However, a pervasive issue known as "ghost networks" continues to undermine these…
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The Link Between Physician Efficiency and Healthcare Network Adequacy
A recent study conducted by Med School Insiders found quite a bit of variation in the number of patients seen by physicians across different practice areas. Orthopedic surgery, diagnostic radiology,…
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Physician Wait Times and Their Impact on Network Adequacy
For health care provider network executives, ensuring robust network adequacy is paramount. It’s the bedrock upon which member satisfaction, regulatory compliance, and overall organizational success are built. However, a persistent…
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The Looming Crisis: Nurse Burnout and Staffing Shortages
The heart of health care is, and always will be, its people. But what happens when that heart is under duress? Health care provider network executives are currently facing a…
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Navigating the Evolving Landscape: CMS Updates to Hospital Price Transparency and What it Means for Provider Network Executives
The drive for greater transparency in health care costs continues to gain momentum. Recent updates to the Centers for Medicare & Medicaid Services (CMS) hospital price transparency guidance, spurred by…
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