by anna@ahmarketingco.com | Mar 18, 2025 | Industry News
One of the strongest drivers of hospital profitability is their patient payor mix. Simply put, commercial patients pay the most. For hospital executives seeking to maximize financial performance, sharing 340B savings in partnership with a provider-owned or other...
by anna@ahmarketingco.com | Jan 10, 2025 | Industry News
Health plan reinsurance provides a safety net against excessive claims, allowing plans to stabilize their finances. One of the key aspects of reinsurance is determining individual retention levels. Here are possible approaches to consider on setting your retention...
by anna@ahmarketingco.com | Sep 13, 2024 | Industry News
For some health plans, this subject is old news. They started a level funding plan years ago to capture some of the group membership erosion they were projecting. However, for some health plans, level funding never really passed the approval process or got the...
by anna@ahmarketingco.com | Jul 31, 2024 | Industry News
In the midst of network innovations like Reference Based Pricing, employers seem to still prefer a national PPO network solution. If you are a regional health plan, partnering with a national network is easier said than done. If you are not of a certain size, your...
by anna@ahmarketingco.com | Jun 24, 2024 | Industry News
Saving Money on Specialty RxA potential solution? Specialty Rx is exploding! We’ve had one reinsurer saying that their clients’ #1 question is, “How can you help us with Specialty Rx?” Specialty Rx is half of drug spend, and J & Q code...
by anna@ahmarketingco.com | May 9, 2024 | Industry News
The use of weight loss drugs like Wegovy is expanding rapidly. The March 29th edition of the Wall Street Journal reported that Elevance and Kaiser Permanente are expanding their coverage for people with heart-related conditions for Medicare Advantage and commercial...
