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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
Artificial intelligence (AI) has undeniably become a game-changer in various aspects of healthcare, offering unprecedented efficiency and speed. Among its many applications, AI holds significant potential in streamlining the claims denial and prior authorization processes that healthcare payers mana...
14 Jan, 2025
The health payer industry continues to undergo a seismic shift, driven by evolving customer expectations, regulatory demands, and the rapid advancement of technology. For CIOs, 2025 represents a pivotal year to align their strategic priorities with these trends, ensuring their organizations stay com...
30 Dec, 2024
Recent Posts
- 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
- Preparing for the Future of Medicare Advantage Star Ratings
- Unlocking the Potential of AI in Streamlining Prior Authorization While Prioritizing Patient Care
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