Q4 2025 payor earnings: what they said — and what it means for providers
In Q4 2025 earnings calls payors signaled a move toward more margin discipline. Lower MLR guidance, tighter utilization, and more admin friction are coming. Providers should pay attention.
The Break Up Big Medicine Act and the future of vertical integration in healthcare
When insurers own PBMs, pharmacies, drug manufacturers, and competing providers, is it coordination — or concentration? Kevin Thilborger takes a look at the Break Up Big Medicine Act and the future of vertical integration.
Health insurance CEOs told Congress they want to lower costs. Providers have heard this before—and Congress has, too
Insurers testifying to Congress last month again promised they are committed to lowering costs, reducing friction, and improving transparency. Sustained follow-through has been harder to find, writes Brandon Edwards, CEO and cofounder of provider-focused healthcare marketing agency Unlock Health.
Lead like a cheetah: why fast, fit, and flexible now define change leadership in healthcare
Healthcare change efforts often stall despite strong strategy. It doesn’t have to be this way. Brian Storts breaks down how fast, fit, and flexible leadership helps organizations activate change, build adoption, and sustain momentum.
When the fox starts teaching poultry management
When a payor helps shape medical education, the risk isn’t knowledge, it’s normalization. Why UnitedHealth’s role in training physicians should concern us all.
What comes next: How providers can prepare for the next era of payor economics in 2026
The burden to justify value is being shifted from the insurer to the provider.
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.
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.