Resources
Unlock Health has deep experience in managed care consulting, revenue strategy, contract performance and negotiations, benchmarking, analytics, and strategic communications
The risks of opting out of the landmark BCBS antitrust settlement
The Blue Cross Blue Shield antitrust settlement offers healthcare providers $2.8 billion in compensation and systemic BlueCard improvements, with opting out posing significant risks of costly, prolonged litigation and forfeiture...
Beyond the payout: How the BCBS antitrust settlement will transform the BlueCard program for providers
The recent $2.8 billion Blue Cross Blue Shield antitrust settlement, coupled with mandated system improvements, promises to address long-standing issues with the BlueCard system, ensuring more timely payments, increased transparency,...
More Medicare Advantage turmoil
Medicare Advantage plans face growing scrutiny and rejection by providers due to payment challenges and administrative complexities, prompting hospitals to reassess contracts and seek strategic support for managed care negotiations...
New era of conflict with independent Blues?
Independent Blue Cross Blue Shield plans are increasingly in conflict with providers due to aggressive cost-cutting measures, high denial rates, and contentious contract negotiations, emphasizing the need for strategic managed...
Debunking the RAND Study: How flawed data is hurting U.S. hospitals
The RAND hospital pricing study, widely cited by employers, insurers, and policymakers, is criticized as methodologically flawed, with misleading conclusions that unfairly portray hospitals as overcharging, risking further financial destabilization...
May you live in interesting times
The current healthcare system, dominated by a few powerful health plans, highlights the urgent need for systemic redesign focused on patients rather than insurance companies, requiring long-term strategies and transformative...
Hospitals are damned if they do, damned if they don’t
Hospitals, facing mounting bad debt from insured patients and pressures from the No Surprises Act, are increasingly requiring advance payments for non-emergency care, navigating criticism while striving to balance financial...
Prior authorizations should be renamed ‘the Care Avoidance Process’
The widespread use of prior authorizations by insurers delays care, undermines physician-patient relationships, and improperly denies treatment, highlighting the urgent need for collective provider action and stronger protections against these...
Is the nation’s largest payor becoming a closed system?
UnitedHealth Group's transformation into a closed healthcare system, driven by its subsidiary Optum, raises concerns about reduced competition, patient choice, and fairness, emphasizing the need for providers to secure protective...