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The U.S. healthcare payer market is on the cusp of significant evolution, with Gartner forecasting an 8.5% growth in enterprise IT spending for this sector in 2025. This increase will drive total spending to $62.4 billion, an investment pattern that underscores the strategic importance of technology...
13 Mar, 2025
Health payer executives understand that navigating today’s complex healthcare landscape requires robust strategies. One framework that has proven critical to long-term success is Population Health Management (PHM). At its core, PHM seeks to improve health outcomes while managing costs and enhancing ...
5 Mar, 2025
The intersection of behavioral and physical health represents one of the most promising advancements in healthcare today. For decades, the fragmented nature of healthcare made it challenging to treat individuals holistically. Behavioral health conditions often went undetected or untreated, further c...
20 Feb, 2025
For Medicare Advantage (MA) plans, stricter quality thresholds from CMS continue to raise the bar for star ratings, making it harder for plans to achieve high scores. In 2025, the average MA Star Rating dropped from 4.07 in 2024 to 3.92, continuing a three-year downward trend. Additionally, only 40%...
13 Feb, 2025
As healthcare payers face increasing operational complexities and heightened member expectations, technologies like AI, data analytics, and core system modernization have become crucial areas of investment. Gartner’s 2025 CIO Agenda for Healthcare Payers: Insights for Strategic Planning* provides ac...
6 Feb, 2025
The coming evolution of Centers for Medicare & Medicaid Services (CMS) Star Ratings marks a fundamental change that demands immediate attention from Medicare Advantage (MA) plans. With an increased focus on clinical performance, beneficiary experience, and equitable care outcomes, the upcoming chang...
22 Jan, 2025
Recent Posts
- The Evolving Landscape of U.S. Healthcare Payers and IT Spending Growth in 2025
- Leverage the Power of Analytics for a Successful Population Health Management Framework
- 4 Key Ways Technology is Integrating Behavioral and Physical Health
- Reverse Falling Star Ratings with Next-Generation UM and Intelligent Prior Authorization
- Healthcare Payer Strategic Priorities: Insights from Gartner’s 2025 CIO Agenda
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