Finance

Rising costs continue to put healthcare industry financials front and center. At the same time, stakeholder interdependencies result in a system defined by complexity and variation. Whether you are a provider, funder, or partner, knowing how industry payment models work is key to both understanding stakeholders' incentives and managing your own margins.

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Health systems must confront the eroding legacy hospital business model

The standard playbook for hospital profitability is no longer sufficient, as the industry faces converging challenges that threaten financial stability. From shifting volume and payer-mix, to weakening non-core revenue sources, hospitals must adapt to survive.

Healthcare in 2025, part 3: How high-cost therapies are changing how we finance care

Transformative, high-cost therapies and diagnostics can offer patients truly tailored treatment. Gain insight into how personalized therapies are creating a need for new ways to finance and deliver care.

The future of health insurance: Government-sponsored coverage through private plans

The health insurance industry is undergoing a transformation, with government-sponsored private plans (through Medicare Advantage, Medicaid-managed care, and the individual market) gaining momentum while employer-sponsored insurance stagnates. The scale of the public segments brings more urgency for oversight from regulators — and increases health plans’ sensitivity to program changes.


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