Resources - Unlock Health

Resources

Unlock Health has deep experience in managed care consulting, revenue strategy, contract performance and negotiations, benchmarking, analytics, and strategic communications

The ups and downs of payor coding practices: how upcoding and downcoding both undermine trust

Payors are inflating patient risk scores to boost their payments from federal programs while adjusting provider claims to pay less.

Q3 2025 earnings recap: higher revenue, elevated costs, and payors prepping to pivot

Having closely followed the Q3 2025 earnings calls from key payors, Kevin Thilborger covers key trends and takeaways.

Exploring Power Imbalances in Managed Care

Kevin Thilborger explores the power imbalance between payors and healthcare providers and discusses three key areas to watch. Originally published in First Report Managed Care.

Rethinking revenue: why health systems need a bigger pie, not just a better slice

Health systems can't rely on collections alone. See how rethinking your managed care revenue strategy can expand margins, strengthen contracts, and drive sustainable health system revenue growth.

More than halfway through 2025, how good were our predictions?

At the start of 2025 we published our predictions for six key areas to watch in managed care. More than halfway through the year, we check in to see how we did.

Months later: Have health insurers delivered on their prior auth promises?

Health insurance companies pledge prior authorization reform, yet providers face ongoing delays and distrust, highlighting the gap between promises and reality.

Learn from North Carolina’s model before other states follow suit

North Carolina is rolling out a "no cost" surgical benefit this fall. Here's what providers in and out of North Carolina need to know.