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August 6, 2014 | Erin McCann

There's been a lot of talk about compliance lately. Federal and state regulations. HIPAA regulations. But, if you're in charge of healthcare security, compliance is far from sufficient, according to one large insurer.


August 5, 2014 | Mike Milliard

Startups and investors from Silicon Valley to the Charles River are chasing after the next paradigm-shifting blockbuster innovation. But are any of new companies developing technology that will truly help transform healthcare?


July 31, 2014 | Anthony Brino

Utah's start-up health plan is offering a new service that could prove attractive to employers and individuals in a state with a growing tech hub, while also putting pressure on established players.


July 23, 2014 | Anthony Brino

The nation's largest health insurer is making its free mobile app available to everyone, in a bid to move the needle on price transparency.


July 18, 2014 | Anthony Brino

More and more, health insurance professionals who design consumer-driven and high deductible plans are using them personally, a trend that bodes well for their improvement.


July 9, 2014 | Anthony Brino

One regional insurer is using a new approach in provider network management, as it aims to tackle a laborious administrative process.


June 12, 2014 | Anthony Brino

If health insurers want to garner new members and keep them well, it may be worth looking internally, at how employees are faring and how managers make decisions.


June 3, 2014 | Anthony Brino

For employees, there can be nothing quite like the paperwork of HR and benefits, and for employers it can be expensive, especially with new ACA reporting requirements. Internet companies are trying to cash in on that, and could also shake up the insurance broker business.


May 27, 2014 | Anthony Brino

Amid the transition to the Affordable Care Act, startup companies looking to augment, service or replace health insurance have been getting record investments.


May 20, 2014 | Erin McCann

As a payer and provider and the country's largest managed care organization with a lot of digital and online patient data, Kaiser Permanente has tried to address privacy and security head-on, and may pave a way for others.


May 14, 2014 | Anthony Brino

Next year, when Americans go looking for the best surgeon or cheapest MRI, many will have free access to a new comparison service started by three insurance giants.


May 12, 2014 | Ben Harris, Contributing Writer

Modernizing code is essential for payers as technology ages and healthcare evolves. How does it work, and what's on the line?


August 28, 2014 | White Papers
Change happens fast in the healthcare industry, and predicting when and how changes will occur is next to impossible. To remain competitive, businesses need to remain flexible. Read how Harvard Pilgrim Health Care, when faced with an end-of-life claims processing platform, saw an opportunity to provide value for the organization and position itself to flexibly respond to industry changes by adopting a component-based solution utilizing service oriented architecture (SOA).

August 28, 2014 | White Papers
While the new consumers entering the health insurance market offer an opportunity for potentially lucrative new business, they come with a built-in distrust of the product they are purchasing. This white paper discusses how effective use of advanced technology and outsourcing can improve service and increase cost transparency for members, building trust and creating relationships that last beyond the next open enrollment.

August 27, 2014 | White Papers
Scott & White Health Plan and Insurance Company foresaw increased manual data-entry processes required to accommodate an influx of new members under the Affordable Care Act. The nationally rated health plan's implementation of EnableSoft's Foxtrot software helped to reduce new network set-up time and time to establish new pay classes, while at the same time increasing productivity and scaling operations without increasing staff.

June 2, 2014 | White Papers
Health plans must not only address today’s security threats, but plan for unexpected emerging risks of the new healthcare marketplace.

June 2, 2014 | White Papers
Today, value-based payments reward successful health outcomes, increased quality of care, and higher patient satisfaction. For health plans, this shift presents dramatic challenges. For many, technology will be the key enabler of these new payment models.

June 2, 2014 | White Papers
Success for payers will be based on their ability to integrate and analyze many types of data, from many sources. Making informatics and medical costs and quality management the last true value proposition for health plans.

May 19, 2014 | White Papers
If your organization enters or changes data manually, or is using a series of macros cobbled together to automate enrollment, claims reprocessing, or panel updates, you’re probably losing time, money, and risking data quality. This study explores the causes, prevalence, and repercussions of these traditional data practices for payers, then shares innovative ways to conquer inefficiency with automation technology.

March 11, 2014 | White Papers
For health insurers, data integrity and visibility are key to successful integration with the Federal Marketplace. However, complex processes and trivial errors can lead to data gaps that impact revenue, profitability and member satisfaction. Adopting a standarized approach to data integrity early in the process is critical to succesfully adapting to the technologies and processes of the Affordable Care Act.

November 20, 2013 | White Papers
Whether they realize it or not, most healthcare payers are losing millions of dollars each year across activities such as COB, subrogation, eligibility, MSP validation, and more. Fortunately, a new generation of "intelligent" cost containment solutions helps cut the losses and achieve significantly improved recoveries, cost avoidance, and increased revenue - all of which support health reform priorities such as medical loss ratio and waste and abuse efforts. This white paper details real-world examples of "intelligent" cost containment success, best practices for improvement, and more.

November 7, 2013 | On Demand Webinars
The healthcare sector has a clear opportunity to modernize care delivery by adopting new data interchange standards and EHR systems. But getting there will first require upgrading aging infrastructure, managing data explosion, and ensuring compliance with new regulations. This translates to more projects and greater costs for IT resources that are already stretched thin. There is a clear need for transformative technologies that will enable healthcare IT teams at payer organizations to tackle the unavoidable wave of big projects faster and with greater efficiency. Watch this webinar to learn how Molina Healthcare drove cost and operational gains in its claims processing environment.

October 9, 2013 | On Demand Webinars
The healthcare sector is going through massive transformation. Payers have to invest in readiness around data delivery to federal and state or multiple health insurance exchanges before Jan 1, 2014 deadline. While the ICD-10 adoption deadline has been pushed back due to industry pressures on regulator - it is still a huge undertaking for any healthcare entity that touches diagnostic or procedural codes. These are just some of the projects that are converging on healthcare IT teams this year. For healthcare CIOs and IT teams and especially application development teams this project overload translates into a cascading capital and operational cost burden. Learn how Presbyterian reduced storage, operational costs and realized significant productivity benefits around critical business processes.

October 9, 2013 | White Papers
Healthcare reform is transforming the US medical insurance sector - creating a dynamic and competitive new market with compelling opportunities for growth. But do you have the necessary responsiveness to capitalize on these opportunities? Here are the five compelling ways technology investment delivers agility you need - and how.

WEBINARS AND WHITE PAPERS

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