The cost of fighting back: why provider-payor disputes are no longer just about rates
Provider-payor disputes increasingly involve payor policies like site of care, downcoding, and claims reviews. Here’s why the cost of fighting back may be lower than the cost of accepting a new normal.
Why the fight over the 340B program is becoming a major hospital revenue battle
Recent 340B lawsuits, state laws, and federal appeals are raising a larger question for hospitals: who controls the value created by 340B, and who ultimately benefits from it?
HCSC 2025 annual report: $1.9B loss changes the conversation
How does HCSC’s $66.8B in revenue become a $1.9B loss? The 2025 annual report completely changes the conversation about one of the country’s largest Blues plan.
Q1 2026 payor earnings: The pressure is moving operationally
Q1 2026 payor earnings revealed rising claims payment delays, tighter utilization management, Medicare Advantage pressure, and growing questions about whether healthcare costs are being managed — or simply redistributed.
The hospital cost crisis is real. The story is incomplete.
The hospital cost crisis is real, but the narrative is incomplete. A deeper look at payor behavior, consolidation, and what’s actually driving healthcare costs.
Healthcare strategy works best when marketing, managed care, and revenue strategy connect
Revenue strategy in healthcare works best when marketing, managed care, operations, and business development align around shared growth priorities. Learn how connected planning, HRAs, and patient acquisition strategies improve financial performance and care delivery.
Will AI make the financial side of healthcare easier?
AI is transforming payor-provider dynamics, but not necessarily in providers’ favor. Explore how payor AI investments may increase denials, slow payments, and pressure healthcare margins.
Disciplined acceleration in healthcare transformation
Moving faster doesn’t guarantee better results. Like the cheetah, speed works best in strategic bursts. Brian Storts explains how disciplined acceleration prevents activation fatigue in healthcare transformation.
Q4 2025 payor earnings: what they said — and what it means for providers
In Q4 2025 earnings calls payors signaled a move toward more margin discipline. Lower MLR guidance, tighter utilization, and more admin friction are coming. Providers should pay attention.