States have increasingly outsourced the provision of Medicaid services to private managed care plans. To ensure that plans maintain access to care, many states set network adequacy standards that ...

ASCs and their urologists can often feel intimidated and ill-equipped to deal with the negotiation process. They may accept what payors offer and begrudgingly sit tight year after year knowing that ...

Managed care organizations (MCOs), situated at the intersection of payers, providers, and patients, are uniquely placed to address these dual gaps. This article outlines 10 leadership priorities—5 ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

“Hospitals are looking for opportunities to partner where assets aren’t necessarily held by an outside company,” says James Swift, MD, chief development officer at MEDNAX, a national medical group. Dr ...

AJMC: How have the concept of managed care and the conversations around it changed over the past 30 years? BAI: Over the past 3 decades, the appearance of managed care has evolved, but its concept ...

Revenue cycle management performance has never been more important. And recent advances in technology, particularly artificial intelligence, offer much potential for healthcare's administrative ...