Payer Systems

Michigan's Medicaid Work Requirement: A Warning to States
Management & Administration Michigan's Medicaid Work Requirement: A Warning to States

Imagine a state pouring millions of dollars into a policy that risks stripping healthcare from tens of thousands of vulnerable residents, only for it to collapse under its own weight just before a global health crisis hits. This isn’t a hypothetical scenario but the reality Michigan faced in early

Home Health Providers Thrive with Tenacity in HHVBP Model
Management & Administration Home Health Providers Thrive with Tenacity in HHVBP Model

In the evolving landscape of healthcare, home health providers face a unique set of challenges and opportunities under the Home Health Value-Based Purchasing (HHVBP) Model, a payment framework introduced by the U.S. Centers for Medicare & Medicaid Services (CMS). This system, which ties Medicare

Flawed Healthcare Rates Spark Call for Transparency Reform
Management & Administration Flawed Healthcare Rates Spark Call for Transparency Reform

The U.S. healthcare system, burdened by an expenditure of $4.9 trillion in 2023, stands at a crossroads due to the fundamentally flawed nature of commercial negotiated rates for health benefits, which exhibit staggering inconsistencies. These rates, shaped through shadowy dealings between payers,

Automation Revolutionizes Medical Billing for Revenue Growth
Management & Administration Automation Revolutionizes Medical Billing for Revenue Growth

The healthcare sector is witnessing a profound transformation as automation emerges as a critical driver of financial success, reshaping the landscape of medical billing with unprecedented efficiency. With operational demands soaring and reimbursement models growing increasingly intricate,

Private Health Insurance Surges in Colombia Amid Crisis
Management & Administration Private Health Insurance Surges in Colombia Amid Crisis

In a striking turn of events, Colombia has experienced an unprecedented 37% surge in private health insurance enrollment, with 1.4 million individuals now covered under prepaid medical plans as of mid-2025, reflecting a profound shift in how citizens access medical care. This dramatic rise unfolds

Post-Acute Nursing Directors Key to Value-Based Care Success
Management & Administration Post-Acute Nursing Directors Key to Value-Based Care Success

In the rapidly evolving healthcare landscape, the transition to value-based care (VBC) has placed unprecedented pressure on health plans to deliver high-quality outcomes while curbing costs, especially in the realm of post-acute care (PAC). PAC, which encompasses recovery services provided in

Loading

Subscribe to our weekly news digest.

Join now and become a part of our fast-growing community.

Invalid Email Address
Thanks for Subscribing!
We'll be sending you our best soon!
Something went wrong, please try again later