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Keep a watchful eye on remote claims processor engagement

Dan Enthoven, Enkata
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Many claims processing organizations rely on distributed workforces to save costs on office space, increase their access to labor, and have a broader talent pool to recruit out of. There are plenty of benefits of this approach, but there are also risks.

Five ideas for future-ready payer platforms

Daniel Knies, CTO, Aldera
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The Affordable Care Act, ICD-10 compliance and the growth of retail healthcare are just a few of the realities payer CIOs now deal with. They are also reasons why features like open architecture and consumer accessibility are much-needed.

Now about that individual mandate

Robert Laszewski, Health Care Policy and Marketplace Review
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Will the 2014 mandate to buy health insurance be enforced come tax time? It sure doesn't look like it.

6 ways to save on member communications

Debbie R. Mabari, CEO, Cody Consulting
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The "cost to do business" doesn't have to be so expensive for government-sponsored health plans. Most payers are overspending on their annual print and fulfillment budget for member communications by 10-15 percent.

Navigating the murky waters of hospital quality and narrow networks

Robert Laszewski, Health Care Policy and Marketplace Review
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It isn't news for anyone to suggest the most expensive hospitals may not be worth the money. But the recent hullabaloo over both narrow networks and hospital quality may be missing the forest for the trees.

Silly Republican insurance reform ideas

Robert Laszewski, Health Care Policy and Marketplace Review
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There are news reports indicating Republicans will be proposing such longstanding health insurance reform ideas as selling insurance across state lines and association health plans.

Healthcare consumerism contributes to patient engagement and cost savings

Karin Ratchinsky, Director of Healthcare, Level 3
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Studies and predictions around customer engagement and behavior trends focus on the empowered, online consumer. Forbes and Marketo cite that consumers expect super-personalized communications, consistent multi-channel interactions and sleek efficient tools. Payers are hit with delivering against these heightened expectations while responding to a host of new regulatory requirements. Luckily this double whammy has a silver lining; the technologies and tools that consumers demand can improve subscriber loyalty and the bottom line.

State HIXs fighting for survival

Anthony Brino, Healthcare Payer News
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The federal government's latest health reform tweaks could complement or disrupt the transition to new insurance marketplaces, depending in part on how consumers fair in the last month of open enrollment.

Extending the Obamacare cancelled policy moratorium

Robert Laszewski, Health Care Policy and Marketplace Review
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The administration has confirmed that the individual policies that were supposed to be cancelled because of Obamacare can now remain in force another two years.

Common ground: Payers and hospitals benefit from direct purchasing of medical devices

Steve Lamb, Lead Partner of Implant Partners
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In a changing healthcare economy, commercial payers have to re-evaluate how they do business with hospitals in order to contain costs while also meeting the demands of their members, many of whom are seeking expensive surgeries such as knee and hip replacements.

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