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Multi-year health plan products have the potential to change a lot about how healthcare business models work today.

Assessing the future of healthcare price transparency requires taking a couple of steps back to review its recent history.

The hospital and health system leaders we work with are extremely concerned about the financial impact their organizations may experience from potentially significant Medicaid policy changes, following the recent passage of a budget resolution by the U.S. House of Representatives.

The future will favor payers that adapt to changing market circumstances with agency and velocity. Payers will need to make tough choices.

FTC sues PBMs over insulin pricing, a House bill would extend telehealth flexibilities, and HRSA awards contracts for the new organ transplant system.

Following the US Senate Finance Committee’s recent white paper on Medicare physician payment reform, the graphic shows how Medicare payments to physicians have not kept pace with inflation.

Ozempic trial shows the drug slows kidney disease progression, a blood-based colorectal cancer test is endorsed for FDA approval, and nursing home trade groups sue over the new staffing mandate.

In recent years, the Medicare Advantage (MA) program enjoyed both rapid membership growth and positive attention from healthcare organizations and advocates. As of the beginning of 2024, 33.4 million Americans were enrolled in MA, up 7% from 2023.

U.S. employers have played a dual role in the health insurance of their employees – both paying for their health insurance coverage and choosing their health insurance options. These two roles have been tied at the hip, but now, ICHRA (individual coverage Health Reimbursement Arrangement) products offer an opportunity to bifurcate that role.

Today, the commercial group health insurance market is hollowing out, primarily driven by affordability pressures that have been building for decades.

In a roundtable discussion, Kaufman Hall Managing Directors Matthew Bates and Nora Kelly and Senior Vice President Max Timm discuss the rise of risk-based contracting in value-based healthcare arrangements, what providers and insurers need to watch out for, and what success in risk-based contracting will look like.

Organizations that pursue consumer strategies and value-based approaches together will be much more likely to achieve their goals while increasing their ability to effectively compete against new industry entrants.