Blogs
Care Management in Uncertain Times: Value-Based Approaches for Dual-Eligibles
As 2026 approaches, healthcare leaders continue to grapple with the volatility of policy shifts, regulatory oversight, and evolving care models. Nowhere is this uncertainty more visible than in the management of dual-eligible populations: individuals enrolled in both Medicare and Medicaid. Review D-SNP-specific strategies that can help health plans strengthen dual-eligible care management in 2026.
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Blogs
Preparing for CMS‑0057‑F: What Managed Care Organizations Need to Know
The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) is a sweeping federal regulation with major implications for managed care organizations (MCOs). With the first deadlines approaching in 2026, this rule introduces both technical and operational changes that are intended to improve the speed, transparency, and coordination of prior authorization processes. Take a closer look at what CMS‑0057‑F includes, what it requires from MCOs, and how organizations can begin planning for compliance.
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Blogs
Comparing BPaaS Providers to Find Your Best-Fit Partner
For health plans and managed care organizations, the right BPaaS providers can be more than vendors. They function as strategic partners equipped to drive operational efficiency, compliance, and scalable growth. But with so many options available, selecting BPaaS solutions can be challenging. This guide explores the key challenges in choosing BPaaS providers, the critical criteria to evaluate, and actionable steps for conducting provider assessments.
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Blogs
From Bottlenecks to Flow: Achieving Clinical Workflow Efficiency Through BPaaS
BPaaS helps optimize clinical workflows by automating routine administrative tasks, reducing manual entry, and encouraging smoother coordination across systems and teams. This model reduces the friction that can slow down healthcare operations and lets staff focus on the clinical priorities that drive outcomes and compliance. Cloud-based BPaaS service models are reshaping how healthcare teams manage complexity.
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Blogs
Transforming Healthcare Finance: BPaaS & Strategic Budget Management
By combining cloud-based infrastructure with outsourced expertise, Business Process as a Service enables healthcare organizations to improve financial oversight, reduce capital expenditures, and drive smarter budgeting decisions. Learn how healthcare finance BPaaS strengthens budget management through cost predictability, real-time analytics, and streamlined operations.
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Blogs
Flexibility, Scalability, Agility: How BPaaS Future‑Proofs Healthcare
Many health plans are exploring future-proofing healthcare BPaaS (Business Process as a Service) as a critical solution. Unlike traditional outsourcing or in-house solutions, BPaaS adoption blends cloud-based platforms with expert services, enabling plans to scale quickly, manage change efficiently, and respond proactively to transformation mandates. Learn how the future-proofing power of healthcare BPaaS helps payers overcome operational barriers, enhance responsiveness, and unlock new opportunities for growth.
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