Health plans that implement VBC programs with clarity and operate with a P&L mindset will drive sustainable profitability—extracting value for members, providers, and their organization.
States are quickly adapting to Medicaid reforms. We highlight notable state-level policy changes and offer strategies for managed care organization (MCO) operational and financial sustainability.
New CMS data through December 2024 reveals a dramatic uptick in No Surprises Act disputes and in resulting reimbursements. We discuss the trends and share five steps for payers to effectively respond.
