What is your managed care contract actually worth?
A negotiated rate isn’t what you actually collect. Learn how a payor contract review can reveal denials, underpayments and delays that erode contract value.
Prior authorization reform: what providers should measure
Prior authorization reform may reduce requirements without reducing administrative burden. Learn what healthcare providers should measure to determine what really changed.
The No Surprises Act created a very expensive surprise
The No Surprises Act promised patient protections. Years later, millions of payment disputes are creating a costly administrative burden for providers.
Q2 2026 payor earnings show a more selective approach to growth
Q2 2026 payor earnings showed it was a pretty good quarter for the country’s largest health insurers. Financial performance generally improved, several companies increased their full-year outlooks, and some of the medical-cost pressure that dominated managed-care results over the past year showed signs of becoming more manageable. The more interesting story was happening in membership. […]
How providers can prepare for emerging regulatory trends in managed care
Learn how providers can prepare for managed care regulatory trends affecting reimbursement, prior authorization, Medicare Advantage, data, and payor strategy.
The access to care blind spot: how healthcare decisions are hiding inside benefit design
Every coverage decision is also a healthcare decision. Explore how benefit design affects access to care and uncover the hidden costs of fragmented coverage.
Six months later: how did we do?
Our mid-year review of 2026 managed care trends examines Medicare Advantage, AI, healthcare affordability, provider-payor disputes, and what’s shaping healthcare next.
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
Who controls the value created by the 340B Program? Recent lawsuits, state laws, and federal appeals are changing the answer.