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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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Integrating Virtual Care: Strategic Imperatives for Provider Network Contracting
Virtual care has transitioned from a temporary clinical alternative into a permanent pillar of health system infrastructure. According to the Telehealth benchmark survey results, Virtual Care in 2025: Hospitals Look…
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Men’s Health Strategy: Mitigating the Financial Impact of Delayed Preventive Care
June is recognized as Men's Health Month, an observance dedicated to raising awareness about preventable health problems and encouraging early detection and treatment among men. While the primary focus of…
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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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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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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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