Tag: Managed Care
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...
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.
The Pivot: The (im)perfect storm hospitals face in 2026 and 2027
In the next 18-24 months, headwinds facing healthcare providers will become a full-blown hurricane. Unlock CEO, Brandon Edwards, explores factors that must be addressed as providers prepare to weather the...
What the heck is going on with MLR and the health insurance business?
Unless patients suddenly stop incurring health insurance claims, there's only one place left for payors to go to get control of rising medical loss ratios: providers. By understanding this, providers...
Q2 2025 earnings for the top payors: the managed care mirage gets murkier
Kevin Thilborger highlights key takeaways from the Q2 earnings calls of top insurance companies.
How will United’s struggles impact healthcare providers?
UnitedHealthcare has spent 15-20 years building a reputation for tough negotiating. Now that they've lost 40% of their value in just a few weeks, what will it be like to...
New webinar: What’s trending in the business of healthcare?
Truths we knew yesterday seem up for debate today. An administration committed to reducing waste doubles down on a program that’s expensive for taxpayers and bad for providers. Rising numbers...
Health insurers say they’ll do better … time will tell if they do
In the wake of Brian Thompson's murder, the public demanded significant changes from health insurers. Will they follow through? Unlock Health CEO, Brandon Edwards assesses their first public statements of...