Original and curated content from the HealthCare Executive Group, our sponsors, partners, and healthcare industry professionals.

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Page 1 of 15

Payment Integrity’s Role in Building a Fair & Equitable, Structurally Sound Payment System

Each year over the last decade, ‘Healthcare Payment’ and ‘Data & Analytics’ have been on the HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leaders; whether payment…

Payment Integrity. Fair and Equitable, Structurally Sound Payment System. Healthcare. payment reform. provider payment models. Value-based care.

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September 13, 2021

Extracting Strategic Value from Delay to Price Transparency Mandates

Staying on top of government regulations and their compliance is an ongoing reality for health plans, health systems, and care provider organizations operating in the healthcare industry.  And oftentimes when…

Delay to Price Transparency Mandate. No Surprises Act (NSA) and Transparency in Coverage (TiC). Machine-Readable Files. Self-Service Price Estimation Tool. HealthSparq.

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September 9, 2021

Payment Integrity: Supporting Frictionless Services & Outcomes at Fair Prices

Historically, payers and providers have maintained ‘arm’s length relationships’ with each party acting in accordance with what they deemed their own best interest. Both parties were wont to hold on…

Payment Integrity. Payer Provider Reimbursement. Fair Price. Accuracy. Appropriateness. Timeliness. MultiPlan.

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August 31, 2021

Impact of Healthcare Policy on ACA Marketplace – Leadership Discussion

The new administration and the pandemic have significantly impacted the United States healthcare delivery system with many changes to health care regulations and policy – particularly in regards to the…

Impact of Healthcare Policy. Legislation. ACA exchange marketplace. Individual Small Group Market. SEP. extended enrollment. Subsidy. American Rescue Plan. open enrollment period. Softheon.

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August 26, 2021

Intelligent Care Management Technologies: Key Considerations & Opportunities

As the healthcare delivery system continues to embrace value-based care and payment models, a number of factors are driving the adoption of intelligent care management technologies by health plans and…

Intelligent care management technologies. Value-based care models. Whole-person care. Patient engagement. VirtualHealth HELIOS.


August 20, 2021

Practical Interoperability Part 2: Trust, Workflow, Value-Based Care Models, & More

‘Practical Interoperability’ means different things to different healthcare stakeholders. In the HealthCare Executive Group’s first Focus Area Roundtable on Interoperability, leaders associated with health plans, care providers, and organizations supporting…

Practical Interoperability. Trust, Workflow, & Value-Based Care Models. HealthCare Executive Group. HCEG. Focus Area Roundtable. health plans, payers. Insurance.

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August 2, 2021

Discussing Barriers to Healthcare Interoperability, Use-Cases, and More – Part 1

‘Interoperability’ – particularly between health plans and care providers – has been a high priority of healthcare executives for years. It ranks #6 on the 2021 HCEG Top 10+ list…

Barriers to Interoperability. Health plans, payers, care providers. Mandates. data transparency, information blocking, HIPAA regulations. Surescripts. Use Cases. Prior Authorizations. Electronic prescribing. Medications. Surescripts

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July 26, 2021

Payer-Provider Collaboration Critical to Meeting Price Transparency Mandates

Ignoring price transparency mandates will not make them go away Will the No Surprises Act be the dagger in the heart of fee-for-service payments? What changes to the No Surprises…

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June 17, 2021

Impact of Healthcare Policy Changes & New Regulations – Healthcare Leader Insight & Opinions

With the new presidential administration, staying abreast of and responding to new and changing healthcare policy changes, legislation, and regulatory activities is more important than ever. And with uncertainties about…

Healthcare Policy Changes. Focus Area Roundtable. HCEG. HealthCare Executive Group. Regulatory. Regulations. Policy. Mandates. Interoperability. Data transparency. Non-Compliance.

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June 1, 2021

Insight on Using Data & Analytics to Address Healthcare Consumer Needs

Health plans have more data and analytics than they typically know what to do with.  The challenge is to use new types of data and advanced analytics like artificial intelligence…

Insight on Using Data & Analytics to Address Healthcare Consumer Needs. HCEG Top 10. Member Data. Insights. Pre-Authorization Process. HCEG. WHCC.

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May 11, 2021

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