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The seven characteristics of successful alternative payment models

To aid APM (re)design and support providers and payers in their value-based contracting strategy, this paper highlights seven characteristics that distinguish well-performing APMs from poorly performing models.

Articles

Digital is reshaping US health insurance—winners are moving fast

Although some payers are succeeding with digital, many risk being overtaken by disruptors. A winning formula of concrete steps can help other payers along the path to digital transformation.

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The Journey to a New Tomorrow: A conversation with Patrick Conway, MD, President and CEO, Blue Cross and Blue Shield of North Carolina

Patrick Conway, MD, President and CEO, Blue Cross and Blue Shield of North Carolina shares his perspective on embracing challenges and disruptions in healthcare, improving the patient experience, and preparing for the future with Celia Huber, Senior Partner, McKinsey and Company in a June 2018 conversation.

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Insights into the 2019 individual exchange market

This analysis reflects carrier participation, pricing, and plan type trends for the 2019 individual exchange open enrollment period. Findings are across 50 states and DC.

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Natural language processing in healthcare

Artificial intelligence (AI) is increasingly being adopted across the healthcare industry, and some of the most exciting AI applications leverage natural language processing (NLP). Simply put, NLP is a specialized branch of AI focused on the interpretation and manipulation of human-generated spoken or written data. In this infographic, we describe a few promising NLP use cases for healthcare payers and providers. We elaborate several specific approaches and their associated applications. Finally, we lay out a case study describing how we have used NLP to accelerate benchmarking clinical guidelines.

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The journey to a new tomorrow: A conversation with Janice E. Nevin, MD, MPH, President and CEO, Christiana Care Health System

Janice E. Nevin, MD, MPH, President and CEO, Christiana Care Health System, shares her perspective on embracing challenges and disruptions in healthcare, improving patients’ experience, and preparing for the future, with David Nuzum, Senior Partner, McKinsey & Company in a June 2018 conversation.