The annual state of change: why 2026 will test our capacity to activate, not just to change
Learn why many transformations stall quietly and how leaders can build the activation capacity needed to turn change into sustained behavior in 2026.
2025 in managed care: the year the quiet parts got loud
In managed care, 2025 wasn’t shocking. It just made the system’s problems harder to pretend not to see.
What to expect in 2026
The pressures shaping managed care now determine how patients seek care, how providers deliver it, and how payors control it.
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
This piece by was originally published in First Report Managed Care The US health care system is undeniably built around the needs of private insurance companies. The market dominance of a few for-profit companies gives them significant control over health coverage for millions of Americans and substantial influence over the policies that govern health 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.