Could Cigna Exiting the Individual Market be an Indictment of ICHRA?
Cigna's exit from the ACA individual market is causing one healthcare expert to question the long-term potential of ICHRA.
Expanding the CJR Model Is a Logical Step in VBC, but Implementation Challenges Remain
CMS is proposing to make its joint replacement bundled payment model mandatory nationwide. Experts say it is a logical step, but warn that mandatory participation could be challenging for hospitals to implement.
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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
Behavioral Health Demand Has Increased by 62% Since 2018. What the Industry Needs to Know
A new report from Trilliant Health finds behavioral health demand has surged since 2018, but workforce shortages and access barriers continue to limit care.
Hospitals & Clinics Still Paid Unequally for Same Care, Research Shows
A new Trilliant Health report revealed wide disparities in provider payments, with academic medical centers and certain payer-affiliated clinics receiving far higher reimbursements than their peers for the same services. The findings emphasize just how much opaque pricing practices continue to drive inequities in the U.S. healthcare system.
Same Surgery, $220K Apart: Why Providers & Employers Need to Rethink Value Amid Price Disparities
A new Trilliant Health report reveals vast price variation for identical healthcare services, even for procedures delivered at the exact same facility. Allison Oakes, Trilliant’s chief research officer, urged providers to prove they are delivering true value for the cost and pressed employers to leverage their purchasing power to demand higher-value care.
Walgreens to Be Acquired by Sycamore Partners: Where Did the Retail Giant Go Wrong?
Walgreens is selling itself to the private equity firm Sycamore Partners. This comes after the company has faced increased competition from online retailers like Amazon. It remains to be seen, however, if Walgreens will perform better under Sycamore Partners.
The Hidden Administrative Tasks Draining Small Practices
Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.
The Promise and Peril of Price Transparency Under Trump’s New Executive Order
President Donald Trump’s latest executive order aims to strengthen enforcement for CMS’ price transparency requirements. Some experts think greater price transparency could reduce healthcare costs by fostering more competition, while others are concerned about the potential effects on hospital-payer negotiations, as well as the practicality of enforcing these requirements.
Why Walgreens Is Reportedly Considering a Private Equity Buyer
Walgreens is reportedly exploring selling itself to private equity firm Sycamore Partners. It might be the right decision for the company, some experts say.
Hospitals Are Facing New Price Transparency Requirements, But Will They Truly Help Patients Shop for Care?
Come January 1, CMS will begin enforcing new price transparency requirements for hospitals. Experts doubt that these regulations will do much to help patients shop for care, but they are optimistic that increasing the amount of publicly available pricing data will help tech companies develop tools that simplify pricing for patients.
Why the DOJ’s Lawsuit Against the UGH-Amedisys Merger May Not Go Anywhere
Experts aren’t sure what the outcome of the DOJ’s recent lawsuit against the proposed UnitedHealth Group/Amedisys merger will be under the incoming Trump administration. The Biden administration has focused more on supporting clinicians, while the previous Trump administration favored corporations. Additionally, one expert noted that this case differs from other antitrust lawsuits because it does not seem to focus on a potential price increase.
The Power of Real World Data to Study Women’s Health at Scale
Veradigm examines key clinical trends, comorbidity profiles, and treatment trends across adolescence, reproductive years, and peri-/post-menopause. Download it today!
Why Pfizer Is Dipping Into DTC Telehealth With PfizerForAll
To address the complicated healthcare landscape in the U.S., Pfizer launched a new direct-to-consumer virtual service called PfizerForAll. It follows Eli Lilly, which launched a similar product in January.
Who is Winning the Retail Pharmacy Consumer Battle?
CVS Health overtook Walgreens as the most popular drugstore retailer, a new report found. However, there is no saying for sure if CVS will keep this lead.
Analysis: Humana is Boldly Going Where Walmart Stumbled
Humana is leasing clinical space at 23 Walmart Supercenter retail stores. The move is logical for the insurer as it builds out its senior primary care business, experts say.
Walgreens’ Finances Are in Dire Straits — But All Hope Is Not Lost
Walgreens’ financial performance is still rocky, but experts agree there is a good chance that CEO Tim Wentworth can lead the company to recovery. To make this happen, Walgreens will have to let go of its retail clinic dreams and focus more on making its core pharmacy business as strong as possible.
Healthcare Is a Frontier Not Even Walmart Could Conquer — And It’s Not Looking Great For Others Either
Walmart’s decision to shutter its healthcare division reflects just how difficult it is to achieve profitability in the primary care and telehealth markets. Experts think retailers simply aren’t prepared to handle the bevy of challenges that come along with delivering healthcare — but could this news also be a sign of the system being broken?