I've been spending less time looking at individual healthcare headlines and more time looking for the patterns underneath them (especially from earnings calls). Because one of the biggest commercialization mistakes founders can make is identifying a painful problem without asking whether that problem will still represent the same market opportunity three to five years from now. Prior authorization is a great example. It's an enormous source of administrative burden, and a l

One of the clearest ways to understand what buyers value is to look at what they are already doing. (Stay tuned for the rest of the strategy maps in the coming weeks. Follow Akros on LinkedIn to stay up to date!) When you review recent strategy maps across major payers including CVS/Aetna, Cigna/Evernorth, Humana, UnitedHealthcare/Optum, and Molina, a pattern starts to emerge. These organizations are not simply collecting vendors. Across the payer landscape, the same themes s

Learn how health plans can look beyond traditional claims analysis to uncover overlooked opportunities for innovation, improve outcomes, and reduce costs—even when claims data captures only part of the patient journey.

Learn how SDOH companies can build a stronger go-to-market strategy by choosing the right buyer, aligning with real healthcare workflows, identifying funding pathways, and proving measurable outcomes and ROI.

Learn how health plans can build scalable Food Is Medicine programs by matching interventions to member needs, integrating accountable delivery partners, and using measurable outcomes to demonstrate clinical and financial value.

Expanding into the U.S. healthcare market requires aligning legal structure, compliance readiness, and payer strategy in a way that supports long-term growth. This workshop is designed to help leaders make the foundational decisions that increase credibility with payers, providers, and investors from the outset.

ERISA creates both opportunities and complexity for healthcare organizations serving self-funded employers. This webinar breaks down how ERISA shapes plan design, financial risk, and decision-making, and what healthcare leaders need to understand when working with employer-sponsored health plans.

Reimbursement strategy can shape how a digital health solution reaches the market. This workshop explores traditional and non-traditional reimbursement pathways, when existing or new codes may make sense, and how founders can evaluate alternative funding models based on their technology and target market.

Quality performance has a direct impact on health plan outcomes, member experience, and financial performance. This webinar explores how health plans can strengthen quality strategy, align investments with measurable goals, and use data and cross-functional collaboration to drive sustainable improvement.

Policy changes from the One Big Beautiful Bill could reshape how families access critical safety net benefits, creating new challenges for health plans to address administrative barriers, coverage gaps, and the financial factors that influence member health.

I was walking the exhibit floor at Becker’s, weaving through the noise of bright booths and polished sales pitches, when something unusual stopped me. A vendor was promoting a platform designed to help health plans manage product and benefit data. Automation, compliance support, efficiency gains. Nothing surprising on the surface. Then the realization landed with a kind of somber force. If a payer cannot manage its own product and benefit data (i.e. the foundational function

Inside health plans, the proposed change to semiannual reporting may rewire the clockwork of financial, actuarial, and commercial decision-making. For digital health tech founders, understanding these internal clocks isn’t optional. It’s how you time your outreach, structure your pilots, and shape the proof points you deliver. If you know when payers make decisions, you stop knocking on closed doors and start arriving exactly when they open. Let’s take a look at the three int

Semiannual reporting offers more than a compliance shift. It extends an opening for payers to rethink not only what they invest in, but how they invest. Semiannual reporting won’t, on its own, change the cadence of actuarial or finance cycles, since those teams will continue running on their own internal timelines. But the shift creates breathing room, allowing for executives to reframe how capital is allocated and how innovation is judged. Traditional capital frameworks a

What happens when health insurers report less often? When President Trump revived his call for U.S. companies to move from quarterly to biannual earnings reporting, the headlines practically wrote themselves. Wall Street worried that fewer updates would make the markets less transparent. Others cheered at the thought of freeing executives from the tyranny of the ninety-day countdown. But in healthcare, and especially among publicly traded insurers like UnitedHealth Group, Hu

Clinical outcomes can create interest, but payer adoption depends on a credible financial case. This workshop explores how payers define and calculate ROI, which outcomes carry the most financial value, and how digital health companies can translate clinical impact into a business case that supports purchasing decisions.