Payer Systems

Centene Returns to Profitability Through Strategic Recovery
Management & Administration Centene Returns to Profitability Through Strategic Recovery

Centene Corporation has successfully orchestrated a major financial turnaround, moving from a significant quarterly loss to a billion-dollar profit by implementing a rigorous strategy that prioritizes sustainable margins over aggressive enrollment growth. This recovery was driven by a deliberate

America Must Overhaul Its Outdated Longevity Infrastructure
Management & Administration America Must Overhaul Its Outdated Longevity Infrastructure

The traditional American social framework is fundamentally ill-equipped to handle the demographic reality of a population that regularly lives into its nineties and beyond without adequate support systems. As the nation navigates the complexities of the current year, the disconnect between medical

Hospitals Are Dropping Medicare Advantage Plans Mid-Contract
Management & Administration Hospitals Are Dropping Medicare Advantage Plans Mid-Contract

A growing number of retirees are facing a distressing healthcare crisis as major hospital systems across the United States abruptly terminate their contracts with Medicare Advantage plans mid-year, leaving patients without expected coverage. This trend signals a significant shift in the landscape

Healthy Professionals Switch to Private PPOs as ACA Costs Rise
Management & Administration Healthy Professionals Switch to Private PPOs as ACA Costs Rise

The traditional health insurance marketplace is currently witnessing a significant exodus of healthy professionals who are seeking refuge from the escalating premiums and restrictive networks associated with government-regulated plans. This demographic, often comprising consultants, tech

ISPOR IMPACT Framework Aligns HEOR With Value-Based Care
Management & Administration ISPOR IMPACT Framework Aligns HEOR With Value-Based Care

The global healthcare sector is currently wrestling with the monumental challenge of shifting from a volume-based productivity model to one rooted in the actual health outcomes achieved for every dollar spent. This transition, widely known as value-based healthcare, has long remained an

South Korean Medical Groups Resist New Primary Care Pilot
Management & Administration South Korean Medical Groups Resist New Primary Care Pilot

The ambitious attempt to restructure South Korea’s primary care landscape has encountered a formidable barrier as medical professionals across the country voice deep-seated concerns regarding the latest government-led initiatives designed to modernize the healthcare system. Launched by the Ministry

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