by Di Simplot | Jun, 2026 | news, Thought Leadership
Combating Escalating Pharmacy Cost through Strategic Benefit Design and ManagementPharmacy costs are no longer a background trend for pharmacy benefit managers (PBMs) and/or employers (“Plan Sponsors”)—they are an immediate call to action that centers around benefit...
by Di Simplot | May, 2026 | news, Thought Leadership
Redefining Utilization Management as a Strategic Enterprise Control FunctionUtilization Management (UM), traditionally viewed as a reactive, administrative cost-containment tool, is undergoing transformation. In the modern, high-stakes healthcare environment, UM has...
by Di Simplot | Apr, 2026 | news, Thought Leadership
The Shift from Recovery to PrecisionHealthcare payment integrity is undergoing a fundamental transformation as we enter 2026. The healthcare industry is moving away from the traditional and more reactive “pay-and-chase” model toward a more proactive...
by Di Simplot | Mar, 2026 | news, Thought Leadership
Health Plan Profitability Challenges as a Call to ActionAs we head into 2026, Health Plans are facing growing profitability pressures stemming from a mix of economic challenges, regulatory complexities, and rising consumer expectations. These issues threaten the...
by Di Simplot | Feb, 2026 | news, Thought Leadership
Preparing Health Care Systems and Providers for Value-Based Contracting As the cost of medical services continues to climb, the health care industry is accelerating the move away from traditional fee-for-service payment models—where reimbursement is based on the...
