Healthcare provider network and plan design

The provider network and plan design refers to the configuration of healthcare providers and the structure of health plans offered to patients. Effective network and plan designs are crucial for ensuring accessibility, affordability and quality of care for healthcare consumers. The elements directly affect cost management, quality of care and member satisfaction.

Exploring the 2026 OPPS, ASC Payment System Proposed Rule
CMS announced the CY 2026 OPPS and ASC Payment System Proposed Rule, which includes a 2.4% rate outpatient rate hike, ...
Omega Healthcare expands agentic AI for RCM with Microsoft
Omega Healthcare is deepening its partnership with Microsoft Azure to enhance its generative and agentic AI capabilities to ...
CMS proposes CY 2026 Medicare Physician Fee Schedule
The proposed CY 2026 Medicare Physician Fee Schedule seeks a conversion factor increase after years of cuts, as well as payment ...

How Stanford Health went all-in on a virtual-first COPD program
Stanford Health Care is collaborating with a virtual-first provider for pulmonary rehabilitation to expand access to chronic care...
Medicare Physician Fee Schedule seeks to expand virtual care
The proposed 2026 Medicare Physician Fee Schedule wants to make some telehealth permanent and expand pay for digital mental ...
Digital health IPOs signal thaw, but new success metrics apply
After an IPO drought, successful public debuts in 2025 mark a potential revival for digital health in the public markets, but ...

What health IT affects patient outcomes, experiences the most?
Although the EHR is widely considered the most impactful health IT on patient outcomes, telehealth is emerging as a key tool to ...
Delayed diagnosis affects 14% of hypertensive patients
EHR alerts and interdisciplinary care teams could reduce the rate of delayed diagnosis for patients with hypertension.
Press Ganey all-in on AI, patient satisfaction measurement
Patient experience surveying company Press Ganey bet big on AI in patient satisfaction measurement, using the tool to streamline ...

Ambient speech improves EHR satisfaction, KLAS report says
Providers report significant gains in EHR usability, reduced documentation burden and physician burnout with ambient speech ...
ONC: Health information exchange happening more via Direct
While the rate of health information exchange via standardized, digital means increases, the rate of fax-based exchange only dips...
How EHR tech eases behavioral health workflows
KVC Health Systems turned to WellSky's EHR platform to gain more flexibility documenting high acuity patients and gathering data ...

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