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Payer

Strategy

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 Learn how to optimize Medical Loss Ratios (MLR), modernize outdated systems, and consolidate data for smarter decision-making.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

Healthcare’s Growing Momentum: 4 Trends to Watch in 2022

Discover which key healthcare trends emerged in the past year and our predictions for 2022.

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

A Look at the Finalized 2022 IQR and PI Programs

CMS dropped the 2022 IPPS Final Rule and made changes to the 2022 IQR and PI program requirements. Here’s what you need to know.

Blog

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Strategy

Healthcare’s Mashup: Turning The Unexpected Into Progress

From laggard to leader. How healthcare’s mashup of organizations, technologies, care delivery and payment models is moving the industry forward.

Blog

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Strategy

No Surprises Act Interim Final Rule: Understanding the Implications

A clear path to evaluating, designing and implementing a custom compliance solution with a broad range of payer and provider services is essential under the IFC.

Blog

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Strategy

Healthcare’s 2021 Midyear Outlook

Halfway into 2021, we step back in retrospect to review healthcare’s progress.

Blog

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Strategy

Changing the Game: Growing our Purpose Post-Pandemic

A message on purposeful growth and post-pandemic healthcare from our Chief Strategy Officer.

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 […]

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