Payer Systems

Can AI Fix the Ailing US Healthcare System?
Management & Administration Can AI Fix the Ailing US Healthcare System?

The American healthcare system, a colossal $5.3 trillion sector, finds itself at a precarious tipping point, burdened by the immense pressure of a rapidly aging population, pervasive operational inefficiencies, and significant macroeconomic uncertainty. This critical juncture, described by industry

Value-Based Care Success Requires an Operational Overhaul
Management & Administration Value-Based Care Success Requires an Operational Overhaul

The era of treating value-based care as a series of experimental pilot programs has definitively ended, giving way to a new standard where it functions as an indispensable operational capability for healthcare organizations. Success is no longer measured by mere participation in alternative payment

What's Behind Cigna's Layoffs and FTC Deal?
Management & Administration What's Behind Cigna's Layoffs and FTC Deal?

Global health insurance giant Cigna has sent ripples through the industry by announcing a significant workforce reduction affecting approximately 2,000 employees, which comes at the same time the company revealed a major settlement with the Federal Trade Commission over drug pricing. The decision

Can Vynca's New CMO Redefine Serious Illness Care?
Management & Administration Can Vynca's New CMO Redefine Serious Illness Care?

The landscape of serious illness care in the United States is fraught with challenges, leaving millions of vulnerable patients and their families navigating a fragmented and often reactive healthcare system. In this high-stakes environment, health technology company Vynca has made a definitive move

HHS Drops 340B Rebate Pilot After Hospital Lawsuit
Management & Administration HHS Drops 340B Rebate Pilot After Hospital Lawsuit

A contentious federal pilot program designed to overhaul how safety-net hospitals are compensated for prescription drugs has been abruptly withdrawn by the Department of Health and Human Services (HHS) following a decisive legal challenge. The proposed 340B Rebate Model Pilot, which was set to

How Is Aledade Driving the Value-Based Care Revolution?
Management & Administration How Is Aledade Driving the Value-Based Care Revolution?

A dramatic transformation is underway within the American healthcare landscape, as the long-dominant fee-for-service model gives way to a system that rewards quality of care over quantity of procedures. At the forefront of this movement is Aledade, a company that has rapidly become a central force

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