It’s Time for a New Approach to Revenue Cycle Management in Healthcare

In healthcare, the process of receiving payment is unlike that of any other business. For most transactions in other industries, the consumer makes a full payment when a service is performed or product is received. Such is not the case in healthcare: Imagine going to Best Buy and saying, “I’ll take the TV home now, […]

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Opening the Course to Price Transparency by Closing the Safe Harbor on Part D Drug Rebates

The Centers for Medicare & Medicaid Services (CMS) is about to publish a proposed rule that – according to the Health and Human Services Department (HHS) – would lower prescription drug prices and out-of-pocket costs for patients and increase pricing transparency. The HHS proposal would eliminate a safe harbor for prescription drug rebates that drug […]

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Now in the Consumer-Centric Healthcare Spotlight: Microsoft & Walgreens

We’ve been steadily predicting the formation of many unusual partnerships as the healthcare industry shifts toward consumer-centric healthcare business models. And our forecasts keep coming to pass: Think of CVS-Aetna, Cigna and Express Scripts and, of course, Amazon’s venture with JP Morgan Chase and Berkshire Hathaway. Now we can add Walgreens Boots Alliance and Microsoft to the list. […]

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Amazon Primes Pharmacy Disruption with PillPack Acquisition

Amazon’s march toward what we’ve called “Prime Health” continues with the company’s announcement that it will acquire PillPack, the online full-service pharmacy that sorts its customers’ medications by dose; packages them by date, day and time; and mails them to the consumer’s home. With this acquisition, Amazon gains another tool for making healthcare easier, faster, […]

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The Frontier Within (Part 3): Green Signals from the FDA for Human Digitization

This is the third in our blog series on “digitizing the human body.” (Also see Part 1 and Part 2.) Human digitization has moved closer to reality, with three recent FDA-related developments strongly suggesting that regulatory hurdles to cutting-edge life sciences technologies are less daunting than generally assumed:  #1: Approval of a Digital Pill The […]

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Drones in Human Health: Transforming Life Sciences in the Wilds of the Healthcare Jungle (Part 2)

In Part 1 of this series, I discussed Dian Fossey’s approach to gaining groundbreaking insights on primate behavior by directly observing and documenting the daily activities of gorillas in their natural environment. I described how applying and combining digital technologies such as drones and artificial intelligence (AI) could enable Fossey-style research at scale to improve […]

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How a Walmart, Humana Tie-Up Would Accelerate Disruption of the Healthcare Value Chain

About two years ago, we conducted visioning exercises about the future of healthcare and its business models. We forecast several “signal events” that – should they come to pass – would mean real business change was under way in healthcare.  Ironically, one of our dummy headlines was “Walmart Acquires Humana.” Score one for our crystal […]

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Five Fundamentals for Creating a Winning Customer Experience Framework in Healthcare

While many in the U.S. are still feeling the effects of winter, the “Boys of Summer” are back in action, pitching, swinging, hitting and base-running their way through baseball’s spring training season. As the weather gets warmer, we’ll hear about the strength and versatility of individual players in particular game fundamentals; but none will be […]

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Cigna & Express Scripts: Yet Another Sign of a Healthcare Value Chain Shakeup

Another day, another healthcare intermediary is absorbed by a player intent on building scale to deliver value, control data and power up a patient-centered business model. Cigna’s announcement of its intent to buy Express Scripts is just the latest development in the ongoing compression of the healthcare value chain. We’ve been predicting these types of […]

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