Sweeping Back The Tide

Looking ahead to 2027, analysts project that health plan costs are going to increase by 9%. The cost drivers of the projected increase – artificial intelligence (AI)-enabled documentation and coding tools, increased provider organization reimbursement pressure, pharmacy cost trends, behavioral health utilization, and higher out-of-network reimbursements – were the focus of our previous executive briefing, Anticipating The Tide.

The question for provider organization executive teams is, what will this cost spike mean for health plan network management and reimbursement strategy – and how will that affect their relationship with health plans? Given the fact that the majority of health care . . .