Health insurance CEOs told Congress they want to lower costs. Providers have heard this before—and Congress has, too
Payor administrative burden continues to grow despite promises of lower costs and greater transparency. Providers have heard those promises before.
Lead like a cheetah: why fast, fit, and flexible now define change leadership in healthcare
Change leadership in healthcare determines whether strategy becomes lasting transformation. Readiness, adoption, and momentum don’t happen by accident.
When the fox starts teaching poultry management
When a payor helps shape medical education, the risk isn’t knowledge, it’s normalization. Why UnitedHealth’s role in training physicians should concern us all.
What comes next: How providers can prepare for the next era of payor economics in 2026
The state of payor economics in 2026 sees the burden to justify value shifting from the insurer to the provider. Here’s how providers can prepare to face it.
The ups and downs of payor coding practices: how upcoding and downcoding both undermine trust
Payor coding practices are inflating patient risk scores to boost their payments from federal programs while adjusting provider claims to pay less.
Q3 2025 earnings recap: higher revenue, elevated costs, and payors prepping to pivot
The Q3 2025 payor earnings report confirms managed care’s core economics are shifting, and not in payors’ preferred direction. Here’s what you need to know.
Rethinking revenue: why health systems need a bigger pie, not just a better slice
Sustainable growth requires more from your health system revenue strategy than collecting what’s owed. It requires intentionally designing for growth.
More than halfway through 2025, how good were our predictions?
At the beginning of the year we published our predictions for the six high-impact managed care trends to watch. Here’s how our predictions have held up.
Months later: Have health insurers delivered on their prior auth promises?
Health insurance companies pledge prior authorization reform, yet providers face ongoing delays and distrust, highlighting the gap between promises and reality.