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Modernizing Provider Network Contracting
PwC’s report, The Future of the Healthcare Payer, makes one thing clear: health care plans must deliver greater value with fewer resources and at an unprecedented pace. But legacy administrative…
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AI in Medicare Advantage: How Health Care Executives Protect MLR and Network Integrity
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
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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TOG Provides Contract Negotiation Support for Health Care Providers
TOG Offers Unmatched Health Care Provider Reimbursement Analysis Success in contract negotiations with payers or health insurers often depends on access to verified data. Many health care providers enter these…
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How Maternal Health Network Strategy Drives Better Outcomes and MLR Stability
National Maternal Health Awareness Day serves as a critical reminder that maternal care is more than a clinical priority. It is a fundamental business imperative for the health care ecosystem.…
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How the ACA Subsidy Lapse Impacts Provider Network Revenue and Stability
The U.S. House of Representatives recently passed a health care package that does not include an extension for enhanced Affordable Care Act (ACA) subsidies. For health care executives managing provider…
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