If you asked five people on your team what your care management or utilization management system can actually do, you’d probably get five different answers. That’s not a knock on your team. It’s just a drift that happens over time. Someone who understood the platform inside and out moved on two years ago. The go-live […]
Read MoreSelecting the right vendor is only the beginning. The real test is whether your organization can hold that partner accountable, protect the investment, and keep the work aligned with the outcome you expected. Health plans rely on an increasingly complex ecosystem of technology, consulting, implementation, and operational partners. The challenge is no longer simply selecting […]
Read MoreWhy most health plans overspend, underdeliver, and can’t clearly explain why Every health plan executive today is under the same pressure: do more with less, improve outcomes, modernize platforms, stay compliant, and protect margin. The problem isn’t ambition. The problem is that most of these decisions are being made without a true understanding of delivery […]
Read MoreA few weeks ago, I had the opportunity to speak at the Spring Managed Care Forum on a topic that continues to surface across payer organizations nationwide: How to stabilize performance in increasingly complex operating environments. One thing became immediately clear during discussions with Medical Directors, operational leaders, and executives throughout the conference: Health plans […]
Read MoreNew offering enables payers to retire enterprise systems while maintaining compliant, on-demand access to historical data LAKE MARY, FL — Impresiv Health, a healthcare consulting and managed services firm focused on technology enablement for payers, today announced a strategic partnership with Harmony Healthcare IT, a leader in legacy data archiving and system decommissioning. The partnership […]
Read MoreEvery year, healthcare organizations prepare for platform upgrades, new releases, enhanced features, and the promise of better performance across care management (CM) and utilization management (UM). On paper, it sounds like progress. In reality, that’s not the case. Many of these upgrades underdeliver, not because the technology falls short, but because the clinical and operational […]
Read MoreAcross the country, states are accelerating the move toward integrated Special Needs Plans to better serve dually eligible populations. Fully Integrated D-SNPs, Highly Integrated D-SNPs, unified appeals processes, and exclusively aligned enrollment are no longer pilots or policy experiments. They are becoming the expected operating model. The strategic intent behind this shift is sound. Integration […]
Read MoreWhy most health plans overspend, underdeliver, and can’t clearly explain why Every health plan executive today is under the same pressure: do more with less, improve outcomes, modernize platforms, stay compliant, and protect margin. The problem isn’t ambition. The problem is that most of these decisions are being made without a true understanding of delivery […]
Read MoreAt Impresiv, we know the pressure of Star Ratings has never been higher. The Centers for Medicare and Medicaid Services (CMS) released Medicare Advantage star ratings in October, showing an average score of 3.65 for 2026, down from 3.92 in 2025. Standards continue to rise, measurement is increasingly outcomes-focused, and scoring updates shift the landscape […]
Read MoreIn 2025, “doing more with less” became a mandate. Health plans invested heavily in platform optimization—care management systems, analytics, interoperability, and workflow automation—expecting efficiency gains and cost relief. As teams look toward 2026, a quieter question is emerging: Why didn’t these efforts deliver the outcomes we expected? The issue wasn’t technology. In most cases, platforms […]
Read More
