What if the success of value-based care isn't just about quality metrics or risk adjustments, but lies in a silent revenue leak tied to utilization? This question might unsettle some healthcare organizations that have been steadfastly focused on traditional metrics. Yet, utilization remains an
As Medicaid continues to serve as a vital lifeline for over 70 million Americans, the impact of policy changes concerning eligibility requirements becomes increasingly significant. For many beneficiaries, these modifications can mean the difference between accessing essential healthcare services
The Affordable Care Act (ACA), popularly known as Obamacare, is approaching a pivotal moment that could affect millions of Americans' access to health coverage. Policy-driven uncertainty, alongside potential insurance premium hikes, presents a complex landscape calling for nuanced market
In recent years, the healthcare and insurance sector has undergone significant transformation, largely due to technological advancements and regulatory changes. AdventHealth Shawnee Mission Medical Center in Merriam, Kansas, has recently become embroiled in a legal dispute with Blue Cross and Blue
In recent years, strengthening regional health supply chains in East Africa has become pivotal in promoting maternal health equity. A notable example of this progress is the cross-border shipment of Oxytocin from Bujumbura, Burundi, to Dar es Salaam, Tanzania. This operation underscores the
In the shadow of recent political shifts, the landscape of healthcare in the United States hangs in precarious balance. As some experts predict an increase in uninsured Americans, startling statistics reveal nearly 9% of the population remains without health insurance today. This stark reality sits
Self-funded healthcare models are grappling with mounting financial unpredictability, a prominent hurdle for employers managing health expenses in an evolving landscape. With healthcare costs surging annually and traditional risk strategies falling short, transformative approaches are emerging as
In the shifting sands of the pharmaceutical industry, a new approach to pricing emerges with transformative potential. The idea of cost-plus pricing is steadily gaining attention, promising increased transparency and improved financial outcomes for independent pharmacies. This budding model
As individuals reach the age of 65, a pivotal moment arises in the realm of healthcare: the decision to enroll in Medicare. This transition can be particularly perplexing for those with job-based health coverage, potentially leading to substantial financial consequences if not properly understood.
The looming expiration of Affordable Care Act subsidies introduces substantial challenges for millions of Americans who have relied on these financial aids to access affordable healthcare. As enhanced subsidies, pivotal during pandemic relief measures, face termination, the potential surge in
