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The national insurers' financial performance in Q3 2025: MLRs continue to worsen even as overall performance is relatively strong
Over the past few weeks, all five national, publicly traded health plans have hosted their third set of earnings calls for the year, sharing their performance from Q3 and their outlook for the remainder of 2025. We make it a point to stay on top of these players’ performance to monitor the health insurance industry’s overall financial position and to see what the data tell us about ongoing demographic shifts, the margin outlook for providers, the real-world/cost implications

Jordan Peterson
19 hours ago12 min read


Revisiting an under-the-radar quality program: Should hospitals take another look at the Patient Safety Organization (PSO) program?
With a new federal measure set to reward hospitals for participating in the Agency for Healthcare Research and Quality's (AHRQ) Patient Safety Organization (PSO) program starting next year—and a fresh government evaluation pushing for tweaks to the program to improve its effectiveness—PSOs have quickly moved from a relatively niche quality program to a potential strategy priority. PSOs play a strategic role by offering legal protections for safety event data and positioning o

Marina Renton
Oct 1011 min read


Are ICHRAs the next 401(k)s? Current trends in employer spending and employer adoption of ICHRAs
Healthcare costs are accelerating faster than anyone predicted, and employers are struggling to keep up. And our team has been having an internal debate about a scenario that seemed unlikely even just a few years ago: could employer-sponsored insurance (ESI) finally be approaching its defined contribution moment—echoing the pension-to-401(k) transition that reshaped retirement benefits a generation ago? Employers have long relied on ESI to attract and retain workers, but risi

Jordan Peterson
Oct 112 min read


The national insurers' financial performance in Q2 2025: A tale of two (types of) payers
Over the course of the past few weeks, all five of the large, publicly traded health plans have hosted their second set of earnings calls...

Jordan Peterson
Aug 1812 min read


Brushing up on the state of healthcare price transparency in 2025
The push toward healthcare price transparency started in earnest nearly 15 years ago, when the ACA highlighted the need for greater...

Marina Renton
Aug 48 min read


What's going on with Payer A.I., denials and audits?
In the last couple of months, we’ve been pulling up chairs with dozens of revenue cycle leaders to understand what’s keeping them awake...

Eric Fontana
Jul 2311 min read


OBBBA's impact on the healthcare industry: Sweeping changes on the horizon
The One Big Beautiful Bill Act (OBBBA) was signed into law by President Trump on July 4 after a narrow 218-214 vote in the House and...

Yulan Egan & Jordan Peterson
Jul 1620 min read


F.W.A: Straight Outta’ D.C. Is CMS about to get even tougher on Fraud, Waste and Abuse?
CMS and the OIG recently announced intention to audit health plans and providers in a set of initiatives that could recoup several billion dollars

Eric Fontana
Jun 1110 min read


The national insurers' financial performance in Q1 2025: Temporary reprieve or signs of stability?
Over the course of the past few weeks, all of the large, publicly-traded health plans have hosted their first set of earnings calls for...

Jordan Peterson
Jun 414 min read


The state of government-sponsored insurance in 2025: How Trump and a GOP-led Congress are approaching Medicare, MA, and Medicaid
Roughly half of the U.S. population gets health coverage through some form of government-sponsored insurance. And with control of both...

Yulan Egan
May 289 min read


Physician practice structure in 2025: What’s changed (and what hasn't)—and what we’re watching moving forward
Later this week, we'll be convening live for this month's Board Briefing webinar to talk about the current state of the physician...

Jordan Peterson
May 197 min read


An emerging strategic imperative? 3 revenue cycle metrics we’re keeping an eye on
If you’ve seen our State of Healthcare presentation, you’ll know that despite provider margins seemingly rebounding at the top line, it’s...

Eric Fontana
May 156 min read
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