Finance/RCM (125)

Job postings, leadership changes and funding rounds can help insurers spot emerging workforce shifts, tailor employee benefits and pursue growth opportunities before annual renewals, says Bradley Taylor, cofounder and CEO of Clarecast.

Starting on Jan. 1, 2027, payment will move from a lump-sum payment at the end of an episode – usually lasting 40 weeks – to more of a fee for service structure, says Anu Sharma, founder and CEO of Millie.

In Ohio, more than half of Medicaid patients are expected to be dropped from coverage, says Casey Williams, SVP of Patient Engagement at RevSpring, who lives in that state.

Copay-only plans, without a deductible or coinsurance, represented about 10% of employer plans in 2023 but now make up an estimated one-third of employer coverage, says Charlotte West, vice president of Surest.

More than half of Medicare beneficiaries are enrolled in MA, and that number is expected to grow to 63%, says John Barkett, managing director at BRG's Healthcare Transactions and Strategy practice.

There's somewhat of a disconnect for consumers between a plan's star rating and how that plan differs from another, says John Barkett, managing director at BRG's Healthcare Transactions and Strategy practice.

Neil Patel, head of ventures at Redesign Health, discusses the rise in mergers and acquisitions across the digital health landscape in 2026 and the market forces driving companies and investors toward greater industry consolidation.

Neil Patel, head of ventures at Redesign Health, discusses the current digital health landscape, how investment has evolved since the COVID-19 pandemic and what investors look for when evaluating the next generation of healthcare companies.

New artificial intelligence models have unpredictable consumption-based costs, says Rhett Alden, Elsevier's CTO of health markets. But "all you can eat models" and inclusive pricing can avoid the need for clinicians to meter tool use.

The underlying challenge is how to fund an industry that's very important but is also perpetually on the brink of bankruptcy, says Kunal Sarda, CEO of Arya Health.

It's a struggle to provide an explanation and clarity on why a claim was denied with the level of detail required, says Fawad Butt, CEO at Penguin Ai.

To get ROI, execs need to apply technology at scale, says former HCA CFO Bill Rutherford, who is now on the Board of Mangers at Ensemble Health Partners.