The Future Healthcare Today Podcast

On the Future Healthcare Today Podcast with Lucas Hunsicker, Kristin Gasteazoro, Senior Vice President of SmartShopper Sales and Client Performance at Zelis, and Reagan Greene, Vice President of Brand, Marketing, and Communications at Blue Cross of Idaho (BCI), dive into the significance of personalized messaging and care delivery strategies. In their discussion, they outline different tactics aim...

In the Future Healthcare Today Podcast , hosted by Lucas Hunsicker, featuring Kristin Gasteazoro, Senior Vice President, SmartShopper Sales and Client Performance at Zelis , and Reagan Greene, Vice President for Brand, Marketing and Communications at Blue Cross of Idaho (BCI), they focus on revolutionizing healthcare experiences and consumer engagement. During the podcast, Kristin emphasizes the i...

Despite healthcare’s critical importance, the intricate nature of insurance plans and healthcare information can often leave individuals feeling adrift. A recent Bend Financial report found that 56 percent of respondents felt “completely lost” when trying to understand health insurance, with even higher rates among people on a family member’s job-based insurance (75 percent) or those on COBRA (68...

Despite healthcare’s critical importance, the intricate nature of insurance plans and healthcare information can often leave individuals feeling adrift. A recent Bend Financial report found that 56 percent of respondents felt “completely lost” when trying to understand health insurance, with even higher rates among people on a family member’s job-based insurance (75 percent) or those on COBRA (68...

People often turn to family, friends, and Google to make healthcare decisions and find healthcare providers. This can lead to confusion and misinformed decisions. Healthcare partners can – and should - step in and offer solutions that simplify this process and provide knowledgeable information. For example, care guidance tools can make the care selection process simpler for members. Healthcare par...

The Affordable Care Act, far from simplifying healthcare, has introduced many more complexities, making the jobs of HR workers even more challenging as they attempt to keep pace with the fast-changing regulatory environment. This has created the opportunity for healthcare brokers to step in to fill knowledge gaps and extend the value of the HR team. In the highly competitive market, brokers need t...

The Transparency in Coverage (TiC) regulations provide further clarification for the use of Machine-Readable Files (MRFs) for the health insurance industry. These rules require that healthcare plans and issuers offering health insurance coverage in individual and group markets disclose in-network provider-negotiated rates through MRFs. The outcome will be increased data transparency for payers, pr...

The healthcare industry has seen its fair share of disruptions in the last few years . With the advent of telehealth and a renewed interest in taking charge of their healthcare, many members have interacted with their plans like never before. However, new interactions can lead to increased expectations for the future of healthcare Zelis conducted a study to discover how satisfied members are with...

Previously, on the Future Healthcare Today Podcast, we heard from Mary Piecuch, Senior Vice President of Product Strategy, and Erick Russell, Director of Network Operations, both at Zelis, about the basics of a reference-based pricing model and what payers, providers, and members need to know to make the most of the solutions and how it can to beneift the patient experience. However, when the conv...

It should come as no surprise that recent events around the world have created an atmosphere of change almost everywhere. People are living radically different lives than they were three years ago , and with those changes comes a desire for the services they use to keep up with their lifestyles . In this environment, it seems almost inevitable that something like the reference-based pricing model...

In a previous episode of the Future Healthcare Today Podcast, the editorial team heard from three healthcare network solutions experts at Zelis about how payers can create and maintain a robust collection of providers and the benefits that this brings. However, the relationship is a two-way street, as there are many tangible benefits to joining a provider network that accrue to the provider as wel...

The healthcare network, made up of providers and managed by payers, is one of the most important aspects of the entire industry. It forms the foundation upon which patients base their expectations , the primary component which payers use to attract members , and that providers use to ensure visibility among patient populations looking for services. However, recent events have fundamentally altered...

Third-Party Administrators (TPAs) and health plans have many things in common, but one that stands out is the challenge both are facing in today’s healthcare industry. With digital transformation, ongoing demographic shifts, and a variety of other long and short-term trends, TPAs and health plans are facing significant headwinds when it comes to creating a modern healthcare network. Despite these...

Accessibility and adequacy are two of the most important elements for healthcare plans today, and digital transformation has made both easier to track and provide. At their core, accessibility and adequacy revolve around the expectation that a health plan member can find not only the right healthcare provider for their needs but that they can do so easily. Being able to easily find the right healt...

In the healthcare industry, a network is only as strong as its providers. As the frontline of care, providers must be ready, able, and willing to help patients as effectively as possible , and while there is no doubt that most, if not all providers, seek to be the best they can be there are times when one provider is better suited to respond over another . But what should networks do when choosing...

In a previous conversation , Madison Goldfischer, Vice President and Head of Product for Member Empowerment at Zelis, joined Future Healthcare Today , to discuss the recently released member empowerment research report. In that conversation, Madison noted that while there were many areas that payers and providers can work to provide their members with more clarity, guidance, and control, one area...

The healthcare provider market has been in flux over the past few years with the challenges of the pandemic impacting healthcare operations among other trends. To help providers better understand and manage the challenges of this uncertain environment, there are important trends to be aware of, like growth in providers contracting with managed care plans across the market segments. Additional find...

On January 1, 2022, the No Surprises Act took effect to protect patients from surprise medical expenses, but it has created tension between payers and providers. For example, on February 23, 2022, the U.S. District Court for the Eastern District of Texas struck down the part of the interagency interim final rule implementing the “independent dispute resolution” (IDR) procedures. When payers and ou...

As 2021 draws to a close, transparency is one of the biggest conversations for health payers. In 2022, some requirements of the No Surprises Act and Transparency in Coverage Rule come into effect. As payers prepare to meet regulatory deadlines – both near term and those further out – it’s understandable that they might have questions they need answered. Both of these regulations are broad and far-...

The No Surprises Act was designed to protect healthcare consumers against surprise billing. For payers , it has made processes more complex, especially relating to ensuring that reasonable and acceptable reimbursements are established and benchmarked by procedure, by provider, and by geography. On September 30, 2021, the Department of Health and Human Services, the Department of Labor, and the Dep...

In an emergency first responders need to focus on the critical situation in front of them and not worry about the security and reliability of their technology and connectivity. When creating a mobile hotspot, using 4G LTE Vehicle Internet (VI) is one way that EMS services can have reliable and fast connectivity in the field. With the connectivity enabled by LTE VI first responders can do what need...

Traditionally, when people think of the national critical infrastructure, they think of the power grid, communications networks, and other physical structures that are fundamental to our society’s daily function. But securing American healthcare is also an essential part of national critical infrastructure safety. While healthcare and public health have long been part of the Cybersecurity and Infr...

With significant investment in research and development being a driver for COVID-19 vaccine distribution and management, it reinforces an emerging need for the critical role AI and IoT to break down distribution barriers and better leverage social determinants of health to ensure equitable care. In addition, enhanced collaboration between public and private sector healthcare agencies will help to...

The need to find a vaccine for COVID-19 resulted in significant investment in research and development, and use of cutting-edge data management technologies and solutions from the digital transformation in public healthcare. Thanks to these efforts, multiple viable COVID-19 vaccines were developed in just six months – with the critical component toward this success being AI modeling. And now, as t...

As a result of the COVID-19 pandemic, telehealth has been brought squarely to the forefront of care in both the public and private sector. After nearly a year of experience with telehealth and high adoption rates, agencies like the Department of Veterans Affairs (VA) are looking to make telehealth services permanent and deliver on telehealth expansion to support mental health services, including b...