payers

Jain argues too many leaders are quietly complicit with a broken status quo.

Bradley Olson, Vice President of Managed Care for Mercyhealth, explains why revenue cycle leaders high claim denial rates to persist....

As payers continue issuing denials at high rates, health systems are shifting their focus inward, emphasizing staff training, clinical integration,...

While complaints about payer behavior are fair game, health systems need to turn to areas they can control to manage...

As CMS reins in Medicare Advantage payments and provider tensions rise, CFOs are rethinking MA strategy, risk exposure, and long-term...

Mercyhealth Vice President of Managed Care Bradley Olson shares the strategies he uses in contract negotiations to keep payers accountable....

During this installment of HealthLeaders' The Winning Edge series, revenue cycle leaders from Mercyhealth and Wellstar Health System share how...

As payers deploy AI to automate claim reviews, revenue cycle leaders share the strategies they are adopting to fight back....

As payers deploy advanced tech to scrutinize claims, health systems like Mercyhealth and WellStar are fighting back with stricter contracts...

The proposal reinforces concerns that MA incentives remain misaligned with clinical reality.

While the number of Advantage plans owned by hospital systems is relatively stable, Mass General Brigham in Boston and others...

Spending hit $5.3 trillion in 2024, but the shift to marketplace plans and a sicker Medicaid pool means more dollars...