In the rapidly evolving landscape of U.S. healthcare, the tug-of-war between payers and providers is continually intensifying, raising the stakes on the strategic maneuvers that shape the industry's ...

Health payers are collaborating to find ways to fix common issues in directory management and credentialing. (Getty Images/ConceptCafe) An innovation council brought together some of the nation’s ...

The aim with a cloud-based deployment is to enable easier and more timely sharing of insights from payers and providers to help educate consumers as they navigate their care journeys, the companies ...

Reducing data silos and boosting transparency in oncology requires payer-provider trust and co-governance, according to Vishnukamal Golla, MD, MPH. Watch part 1 to learn about the frustrations payers ...

Administrative efficiency is a perennial focus for payer chief financial officers (CFOs) and for good reason. Administrative costs represent roughly 15% to 25% of total U.S. healthcare expenditure, as ...

"We believe that transparency can help us do better," said Scott Wilkerson, adding that it's not common for doctors to get large amounts of claims data about their patients from insurers. That's what ...

This voice experience is generated by AI. Learn more. This voice experience is generated by AI. Learn more. For payer-provider collaboration to truly work, it has to start with an aligned strategy ...

Payer-provider clinical data exchange plays a critical role in payer operations, helping streamline workflows and improve patient care. Traditionally, this exchange ...

The appearance of optional payment methods is a reminder that payers and providers need the ability to pursue the best payment models for their needs. There are expenses associated with each payment ...

As someone who has spent a career immersed in healthcare data and finance, I’ve had a front-row seat to the often-frustrating dance between providers and payers. In 2023 alone, approximately 425 ...

“Nobody knew healthcare could be so complicated”. Well, nobody except everybody that works in the business of healthcare, or has had to navigate the system as a patient, provider or payer.

For years, healthcare leaders have emphasized the importance of payer-provider collaboration. As margins tighten, regulatory expectations evolve and value-based arrangements expand, alignment between ...