Health plans are undergoing a transformation as they evolve their capabilities and business models to not only use data in new and innovative ways, but also cope with the increasing volume, variety and velocity of data. Given the impact COVID-19…

On June 30th, CMS announced it was enhancing its Program Integrity efforts that focus on addressing improper Medicaid payments and CMS oversight of state Medicaid programs. The announcement introduced 8 initiatives, including stronger audit functions, enhanced oversight of state contracts…

In this market update, HealthScape Advisors explores trends in carrier – provider partnerships and defines the “missing ingredient” in many such models: effective consumer engagement. As the centerpiece of this update, we examine the innovative elements of a collaborative partnership…

MACRA offers provider organizations strategic opportunities to think differently about their business models and pursue sustainable growth and margin levels. With increased accountability stemming from MACRA and related APMs, patient economics has come at the forefront of long-term strategy development.…