Ensuring a Successful Open Enrollment: Key Areas for Healthcare Payers & TPAs
As healthcare payers and third-party administrators (TPAs) gear up for the open enrollment period (OEP) and annual enrollment period (AEP), ensuring a […]
Maximizing Member Retention: Transforming Pain Points into Positive Experiences
Member retention is paramount in a competitive healthcare landscape. A classic Harvard Business Review study revealed that a mere 5% increase in […]
Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 2
In Part One of this series, we examined the initiatives Gartner identified as key areas for acceleration,1 following their extensive evaluation through […]
Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 1
U.S. healthcare payers and third-party administrators (TPAs) face a complex array of business and technology initiatives driven by evolving market conditions and […]
Building Trust in Healthcare Payer Data: 3 Keys to a Reliable Data Quality Strategy
In the age of big data, healthcare payers and third-party administrators (TPAs) are overwhelmed by vast amounts of information, underscoring the importance […]
2026 CMS Interoperability and Prior Authorization: Key Strategies for Healthcare Payer Readiness
In January 2024, the Center for Medicare and Medicaid Services (CMS) issued the Interoperability and Prior Authorization Final Rule CMS-0057-F, heralding a […]
Achieving Member Retention Excellence: Strategies for Healthcare Payers
In today’s competitive healthcare landscape, member retention is paramount for all health plan types. Retaining existing members is significantly more cost-effective than […]
Navigating the TEFCA Terrain: A Roadmap for Healthcare Payers
In an era of paramount digital transformation, the Trusted Exchange Framework and Common Agreement (TEFCA) emerges as a pivotal beacon for healthcare […]
Celebrating Data Privacy Day: Where Security Meets Innovation in Claims Processing
January 28th marks an important date for all sectors dealing with sensitive data, especially in the healthcare industry. It’s Data Privacy Day, […]