Insights

For Medicaid plans that enjoyed a surge in business during the pandemic, this rapid decline in the market may be disheartening, and the large rapid shifts in the Medicaid risk pools will be challenging to manage to target profit margins in the near-term.read more

In recent years, the Medicare Advantage (MA) program enjoyed both rapid membership growth and positive attention from healthcare organizations and advocates. As of the beginning of 2024, 33.4 million Americans were enrolled in MA, up 7% from 2023.read more

Walmart’s failure as a healthcare provider points to some big problems in U.S. healthcare, including a difficult business model, an unfriendly reimbursement model, and a basic healthcare expense-to-revenue problem.read more

The decision to partner with another health system is always a high-stakes decision for a board. The creation of a community foundation is one way to ensure that a health system’s focus on its community remains intact, with new potential to improve the lives of community residents.read more

The many forces driving some hospitals to financial distress make it impossible to maintain the status quo. Leaders can move beyond a binary close-or-don’t-close decision to reconsider what it means to deliver healthcare in communities that struggle to support a hospital.read more

Health system leaders can no longer afford to think of APPs as extenders or expensive scribes. They must work to effectively integrate APPs across clinical settings and develop the operational and financial data points needed to monitor the efficacy of that integration.read more

With hundreds of competing priorities, hospital executive teams must focus on something they that they know they can spend time on and get real results from. An intense focus on improving length of stay gives hospitals a significant advantage in financial performance.read more

The Department of Justice, Department of Health and Human Services, and Federal Trade Commission recently issued a request for information on consolidation in healthcare markets. Kaufman Hall raises several concerns regarding assumptions and methodologies underlying the request.read more

The employed physician model is coming under stress at many health systems. Given the growing financial pressures that health systems face, they must rethink how they are deploying scarce financial resources and physician talent across the enterprise.read more

While the urgency for healthcare organizations to remodel their ambulatory care business has never been more critical, two pivotal strategies — process standardization and patient-centric care — can help leaders turn the tide.read more

The moral issues coming at executives today are increasing exponentially in complexity, frequency, and intensity. Literature can help cultivate a practice of judicious thought that is as sophisticated as these issues demand.read more

A five-step design process used by the SpaceX engineering team provides a framework for healthcare leaders seeking to transform how patients access their health system.read more