Industry Insights

7 Questions to Define Healthcare Enterprise Growth Objectives
To accelerate growth of your healthcare enterprise, you must have a clear and comprehensive understanding of who, what, and how effective you are now. This understanding forms the foundation for determining how much and in what you will have to invest to optimize your...
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3 Key Questions Driving Your Healthcare Enterprise Growth Strategy
Accelerating growth is now a strategic imperative for every healthcare enterprise. The days when health plans, TPAs, providers of all types, and healthcare industry product, technology, and services vendors could operate comfortably with static or slowly growing...
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How to Ensure Contract Success as a Medicaid Managed Care Organization
Increasing healthcare costs are driving policy makers and government payers to accelerate Medicaid programs’ focus on value. Medicaid managed care contractors have a strategic imperative to ensure their core business and supporting operations deliver the value...
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Don’t Make This Critical Business Development Mistake
Yesterday I had uncomfortable conversations with two prospective clients offering complex enterprise solutions to large healthcare industry organizations. They both were asking us to help them shortcut the business development process and get them directly in front of...
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Balancing Access, Cost, and Quality Through Plan & Network Design
Driven by steady cost increases combined with various aspects of public policy, the healthcare industry is once again in a state of increasing instability as the revolutionary transition from activity-based to value-based care gets underway in earnest. Concurrently...
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Designing an Accountable and Integrated Value-Based Health Plan
Health benefit plan and associated provider network design are foundational to meeting plan sponsor objectives. Here are two key health plan and network design considerations for employers and payers/administrators as they shift to increasingly value based and...
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5 Key Requirement Considerations for Value Based Health Plans
Traditional health plan designs and operational approaches created to reimburse network providers at varying negotiated levels based on activity are no longer sufficient and may soon be outmoded. They are evolving to accommodate new value based concepts of what it...
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4 Payer Strategies to Optimize Specialty Drug Management
Specialty drug management programs are complex by nature with disparate multiple stakeholders. Increasing availability and cost of specialty drugs create an unsustainable financial burden for payers. How do you most effectively integrate and manage the many detailed...
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Legal Compliance for ACOs under the Medicare Shared Savings Program
As a service to our healthcare industry readers and clients, Arlington Healthcare Group constantly curates and shares valuable content from a variety of sources. John Shire is an attorney and Partner with Fox Rothschild LLP. He is a recognized expert on legal issues...
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What is International Medical Tourism
Medical tourism is actually a relatively minor subset of medical travel – where patients travel out of their local market for medical care in search of some combination of lower price, higher quality, faster access, and access to locally unavailable treatments or...
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