Latest insights

Articles

The granularity of Medicaid MCO growth

Despite present uncertainties, MCO leaders can still aspire to grow—and make decisions to support that aspiration. Our research shows that the key sources of growth for Medicaid MCOs are strategic, not operational.

Artificial intelligence in health insurance: Smart claims management with self-learning software

At health insurers, artificial intelligence can strengthen claims management by systematically identifying and correcting errors while avoiding ineffective interventions.

Articles

The Sanitas journey: A digital business model at its core

In this interview, Otto Bitterli (Chairman of Sanitas Health Insurance) discusses the company’s digital transformation and its commitment to being an innovative long-term partner to its customers.

Articles

Delivering bold performance in an ever-changing healthcare landscape

The odds are stacked against healthcare organizations as they pursue sustained growth and differentiated performance. Six strategies can help them achieve successful transformations at scale.

How technology and payment trends are impeding revenue excellence
Articles

How technology and payment trends are impeding revenue excellence

Recent trends are affecting providers’ revenue cycles and altering how providers should manage those cycles. Basic RCM is no longer enough.

Articles

Individual market enrollment dropped 10-12% year-over-year as of the end of first quarter 2017

Enrollment in the individual market decreased by about 2 million members between Q1 2016 and Q1 2017. However, membership changes differed considerably between the on-exchange and off-exchange markets, and between carrier types.