by Di Simplot | Mar, 2026 | news, Thought Leadership
As 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 financial sustainability for health insurers and health...
by Di Simplot | Feb, 2026 | news, Thought Leadership
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 quantity of services delivered— toward value-based payment systems. These...
by Di Simplot | Jan, 2026 | news, Thought Leadership
In this second in our two-part series on the future of Medicare Advantage, we will cover longer term strategies for sustained success in light of both the internal and external challenges highlighted in our first article on this topic.In order to maximize...
by Di Simplot | Dec, 2025 | news, Thought Leadership
Medicare Advantage (MA) plans have long been a cornerstone of growth and profitability for major insurers, buoyed by generous federal reimbursements, aggressive medical services coding strategies, and enticing member benefits. However, the landscape is shifting...
by Di Simplot | Nov, 2025 | news, Thought Leadership
Healthcare transformation has experienced renewed momentum in recent years, largely driven by the increasing demand for care and the continued high cost of providing it, along with ongoing innovation within the healthcare industry.The demand for care is rising...
by Di Simplot | Oct, 2025 | news, Thought Leadership
Artificial Intelligence (AI) is transforming healthcare operations by automating tasks, optimizing resource allocation, and improving overall efficiency. AI-powered systems can handle administrative duties like appointment scheduling, billing, and patient record...
