Payer Insights
As insurers attempt to cut costs, prior authorization has become a bureaucratic choke point in American healthcare. Initially conceived to promote treatment efficiency and patient care, prior authorization has grown to be much more burdensome—learn more about its functions, demands, and its influence on the provision of care.
More than half of all Medicare beneficiaries are enrolled in Medicare Advantage plans. Despite it's large size, Medicare Advantage is a relatively new program with only a few decades of existence. Learn more about the origins of this transformational program and how it grew into the staple of healthcare it is today.
Can forcing hospitals to provide patient care on a fixed budget truly drive innovation? What if financial success depended more on prevention rather than procedures? The Maryland All-Payer Model serves as an excellent answer to these questions, making it an essential case study in the search for a more sustainable health care system.
Picture a healthcare landscape without insurers, where employers directly shape affordable, high-quality care—could this be the future? Discover the benefits, challenges, and real-world impact of this innovative approach, and learn more about how Direct-to-Employer (D2E) contracting is redefining workforce health.
Why doesn't our current healthcare system emphasize preventive care? Can healthcare systems realign themselves to value prevention instead of volume? Learn about integrated providers and how their success is based on the health of their patients—and what means for the future of American healthcare.
Are employers overlooking a key tool for controlling healthcare costs? Learn how high-deductible health plans (HDHPs) with health savings accounts (HSAs) can reduce premiums and promote smarter healthcare spending. As costs rise, could this model be the answer to balancing affordability and employee well-being?