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Payer
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Reducing Medical Loss Ratio and Enhancing Member Care
Discover how BCBS organizations can reduce Medical Loss Ratio and enhance member care while managing rising healthcare costs and growing regulatory demands. This exclusive eBook by Emids offers actionable strategies across five key pillars—operational efficiency, MLR optimization, interoperability, member engagement, and compliance. Learn how to optimize costs, improve member satisfaction, and drive sustainable growth.
eBook
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Payer
Strategy
Sustainable Cost Optimization for Payers: Unlocking Efficiency and Growth in Healthcare
Healthcare payers face mounting challenges balancing rising costs, regulatory demands, and member expectations. Learn how to optimize Medical Loss Ratios (MLR), modernize outdated systems, and consolidate data for smarter decision-making. Packed with insights from Emids’ 30+ years of healthcare transformation expertise, this eBook provides the tools to future-proof your organization and drive sustainable growth.
Blog
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Strategy
Moving Forward with the No Surprise Billing Requirements
In the first rule, Part I of the no surprise billing requirements, health plans were required to implement protections against balance billing and out-of-network cost sharing for emergency services, non-emergency services rendered by non-participating providers at specific facilities, and air-ambulance services by non-participating providers. This rule, Part II, does not change that but offers clarification […]
Blog
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Strategy
Here We Go Again: The Historic Consolidated Appropriations Act, 2021 – Are You Ready for January 1, 2022?
On December 27, 2020, the Consolidated Appropriations Act, 2021 was signed into Law. As the enactment timing was during the holiday season, the Act could be compared to a fruitcake; you may want to avoid it because of the suspect dried fruit, but yet the yummy spirits-soaked cake pulls you in. Referred to as the fifth longest […]
Blog
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Strategy
Optimize Operations: Lasting Transformation Beyond the C-Suite
“Move fast and break things” has never been healthcare’s motto. Pandemic pressure forced innovators, enterprises and investors to transform and reshape discovery, care delivery and whole-system approaches to improving one’s well-being faster than ever to meet consumer and business needs during a pivotal moment in time. As the pace of disruption accelerated, payers and providers […]
Blog
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Strategy
Transform Care: Why Healthcare is Just Getting Started
The urgency of COVID-19 proved that the notoriously slow healthcare industry can swiftly remodel outdated ways of working to usher in change. With this newfound momentum, we’re finding that speed to market is becoming the priority as the red tape is being stripped away, and bureaucracy is bringing digital triage, virtual care and new patient-facing […]