Jay Godla

A detailed look at the potential ways the healthcare collaboration between Amazon, JP Morgan, and Berkshire Hathaway could spawn innovation and disrupt the current healthcare system.

The article explores how healthcare companies can enhance their business models that can withstand uncertainty and change in a turbulent environment.

The article explores the potential impact of adopting the multitude of alternate payment models in driving down medical waste / medical costs.

The paper explores the potential impact of 18 critical trends affecting the healthcare industry, simulates the market evolution under three broad scenarios, calls out potential winners and losers, and implications to the various participants on how to adapt their strategies to capitalize on the impending transformation.

Narrow provider networks hold great promise for health insurers, yet they are still a new and evolving concept — and some current offerings have fallen short of expectations. Payors can build truly high-performance networks by applying three criteria to network design: the total cost of care, the quality of care, and consumer preference.

On January 26, the Department of Health and Human Services (HHS) made a historic announcement. The Medicare program, which in 2012 provided insurance for more than 49 million older Americans, has historically functioned as a fee-for-service (FFS) payor, reimbursing providers for the volume of services they render. In 2014, Medicare made US$362 billion in fee-for-service payments. But as part of an effort to bring government spending on healthcare under control, Medicare is moving to a new… Show more

On January 26, the Department of Health and Human Services (HHS) made a historic announcement. The Medicare program, which in 2012 provided insurance for more than 49 million older Americans, has historically functioned as a fee-for-service (FFS) payor, reimbursing providers for the volume of services they render. In 2014, Medicare made US$362 billion in fee-for-service payments. But as part of an effort to bring government spending on healthcare under control, Medicare is moving to a new paradigm—focusing on outcomes and the value of service provided, rather than volume. Instead of simply reimbursing providers according to set formulas, the agency has been experimenting with alternative payment models, such as accountable care organizations, bundled payment arrangements, and medical homes. Show less