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Resources

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

2023 revenue challenges: Turning the tide in 2024

While 2023 will always be celebrated as the year that Covid-19 shifted from a pandemic to an endemic state, providers across the country still faced significant financial challenges in 2023. From ongoing issues with Medicaid redeterminations and reimbursements to issues related to the huge growth of Medicare Advantage to shifting commercially insured expectations regarding care delivery, many hospitals and health systems are still fighting across multiple fronts to keep their doors open. In this

Denials by bots: Why providers need to keep an (even closer) eye on claims

Providers and payers are arguably the most important stakeholders in our healthcare ecosystem, yet the two groups have a long history of acrimony. While it’s tempting to point the finger at contentious contract negotiations, the events that occur after a contract is signed play just as big a role in perpetuating ongoing conflict as the negotiation process itself. The majority of provider organizations that we work with at Unlock Health – and our clients run the gamut from small, independent hos

Shifts in healthcare, provider hurdles, & the flywheel effect

In the “good old days” — let’s call that period pre-2008 — the majority of commercial insurance was full-risk; Increases came out of payor profitability rather than employers’ and consumers’ pockets, and patients were protected from high out-of-network/out-of-pocket costs. In 15-20 years, everything has changed. A lot. UnitedHealth Group is the poster child for this seismic shift in the underlying design of the healthcare system. At the end of the day, it’s all about leveraging your scaled asse
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