Prior Auth is Done. Steerage is Healthcare's Last Battleground
CMS Administrator Dr. Mehmet Oz announces a new initiative to roll back prior authorizations at the HHS building in Washington, D.C. on June 23, 2025. Rebecca Pifer/Healthcare Dive.
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TEFCA Will Reshape the Market: Why Conveners Must Differentiate Beyond Infrastructure
When the next wave of QHIN RFPs hits the market in 2025, evaluators won't only be asking "Can you exchange data?" They'll be asking "Can you guarantee your member experience?" The difference will determine winners and losers in a market approaching nationwide scale.
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Zocdoc is Bleeding Payer Revenue While You Foot the Bills
Your members are booking appointments on Zocdoc. You're paying the out-of-network bills. Zocdoc is collecting subscription fees from the providers who are draining your network. And somehow, this has become the accepted status quo in healthcare consumer experience.
The “Tragedy of the Commons”: Why Provider Directories Must Fail
Every health plan executive knows the frustration: you spend millions building comprehensive provider networks, invest in directory accuracy initiatives, and create member portals with sophisticated search capabilities.