ProspHire

ProspHire is a national management consulting firm exclusively dedicated to healthcare. Our purpose is helping people prosper everyday.

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We’re heading to the 15th Medicare Stars, HEDIS, Quality & Risk Forum & RISE Qualipalooza this summer. If you're attending, be sure to connect with Andrew Bell & Rebecca Luketich to learn more about how ProspHire is supporting healthcare organizations: https://t.co/SNsNzo6nsE

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For years, Medicare Advantage plans focused on improving Stars performance. Today, many are focused on protecting it. We explore why the Stars program is entering a new era, one defined by fewer measures, greater emphasis on outcomes & less room for error: https://t.co/tPrAFWsAqo

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You can have the right strategy, the right data, the right solution and still fail. Why? Because adoption isn’t logical. It’s human.

This episode breaks down the behavioral barriers leaders overlook and how to design for real execution: https://t.co/r6L18bjDlu

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We’re proud to share that ProspHire has been named one of Modern Healthcare’s 2026 Best Places to Work in Healthcare. Thank you to our incredible team for making ProspHire a place where people feel supported, challenged & empowered to do their best work: https://t.co/OL9e6keOeH

[ProspHire @prosphire]

Most healthcare leaders assume: if the strategy is right, people will follow. But that’s not how decisions actually get made. In Episode 2, we unpack why logic alone doesn’t drive behavior and what it takes to design change that actually sticks: https://t.co/ayKkihHGf6

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Medicaid programs are entering a period of sustained pressure. We’ve explored where pressure first surfaces, from hospitals to managed care to structures Medicaid programs rely on. Medicaid sustainability will be determined operationally: https://t.co/jeBRX8kDEW

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Most organizations are still trying to force change. The ones getting ahead are designing for how people actually behave. Episode 2 unpacks the behavioral barriers behind failed initiatives & what it takes to make change stick in today’s environment: https://t.co/qvvFpHKTGz

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Rural transformation needs an operating model. It isn’t one initiative, it’s a coordinated shift across: care models, workforce, technology, payment & performance. That’s why we launched our Rural Health Transformation Center of Excellence: https://t.co/hLxfp8O3Kx

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Compliance is becoming the difference between organizations that can scale and those that get slowed down by risk, audit or rework. We broke this down in Season 4, Episode 1 of Soaring to New Health. https://t.co/sH1Sc4CpTY

[ProspHire @prosphire]

From Medicaid pressure and Stars Performance to compliance as infrastructure, April reinforced one thing: execution is where performance is won or lost. Here’s the topics and conversations we covered.

[ProspHire @prosphire]

Technology won’t fix rural health on its own. Yes, it's is a major focus in health transformation effort: new platforms, expanded telehealth and data investments. But technology doesn’t change outcomes on its own.

Read the insight: https://t.co/hLxfp8O3Kx

[ProspHire @prosphire]

A new compliance framework for Medicare Advantage: the first in more than two decades. Regulators are tightening expectations & the margin for error is shrinking. The plans that adapt early will be in a very different position than those that don’t: https://t.co/HChRYjnYRn

[ProspHire @prosphire]

Andrew Bell will be speaking at the 17th Annual Medicare Market Innovations Forum on May 5;

He’ll cover:
• Where SNP growth is accelerating
• The operational and compliance reality behind it
• How care model design drives performance and Stars
• What plans need to do next

[ProspHire @prosphire]

Managed care organizations are increasingly responsible for stabilizing care delivery, often without corresponding increases in tools, staffing models or operational infrastructure. Read how Managed Care is quietly helping hold the system together: https://t.co/jeBRX8kDEW

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Most organizations don’t fail at compliance, they fail by bringing it in too late. When compliance is treated as a bolt-on, you’re not reducing risk, you’re building it in. The shift is simple: compliance isn’t overhead, it’s part of how you operate: https://t.co/z74bO8B9fo

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Most healthcare initiatives don’t fail because of bad strategy. They fail because execution breaks down. We asked where performance actually falls apart: unclear ownership, resistance to change, lack of follow-through.

This isn’t about better ideas, it’s about executing them.

[ProspHire @prosphire]

Medicaid expectations continue to rise & operating models haven’t kept up. As hospitals absorb financial pressure & access risks increase, Medicaid programs are being asked to stabilize care delivery with structures built for a simpler system Read more: https://t.co/MYeZM2Bmwx

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The biggest risk in rural health transformation isn’t funding, it’s underestimating the operational lift.
Strategies call for: new care models, expanded behavioral health access, digital modernization & stronger performance oversight. Explore more: https://t.co/w73TLicIEY

[ProspHire @prosphire]

We’re joined by Jessica Zeff & Andrew Bell to break down what happens when compliance is reactive and what changes when it’s built into operations. In today’s environment, compliance doesn’t slow you down; it determines how confidently you grow: https://t.co/98BiZbkUnR

[ProspHire @prosphire]

CMS made Stars simpler while making it harder to perform: fewer measures, less buffer & higher stakes. Performance is no longer owned by one team, it’s produced across the organization.This isn’t about more strategy, it’s about how well the work gets done: https://t.co/cvSgHl4yQv