Latest news being reported on payers and the health insurance industry including news from American Gastroenterological Association, UnitedHealthcare, Cigna, Independence Blue Cross, CVS Health, UnitedHealth Group, BCBSA, Humana, AMA and more.
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By Jeffry A. Peters – In the evolving landscape of healthcare, hospitals continue to grapple with financial challenges, often operating on razor-thin margins of less than 2%. A significant factor contributing to these financial woes is the losses incurred by employed physician practices.
By Belinda Cridge & Krithika Srivats – Facing both revenue and expense issues and exasperated by clinician shortages, hospitals are increasingly noting denials in the danger zone. “Danger zone” translation: Denials are increasingly higher than 10%, costing significant dollars in lost or delayed reimbursements.
By Dr. Benjamin Barlow – The urgent care industry has faced unprecedented challenges and opportunities in the past few years due to the COVID-19 pandemic and its aftermath. Urgent care clinics have seen fluctuations in visit volumes and changes in acuity of care against the backdrop of evolving patient expectations.
Accountable care organizations have been around in Medicare for more than a decade, generating more than $22 billion in savings and giving back more than $8 billion to the Medicare Trust Fund. But a handful of ACOs has consistently been at the top of the list of top savers, including…
Latest news being reported on payers and the health insurance industry including news from Cedar, Independence Blue Cross, CVS Health, UnitedHealth Group, Oscar Health, Vivante Health, and more.
By Eric Demers – In 2022, 20% of adults said they or their family received an unexpected medical bill. The No Surprises Act, which went into effect last year, is better late than never. A bipartisan effort to protect patients from unexpected healthcare expenses, the NSA minimizes surprise billing and makes…
By Mo Weitnauer – Healthcare quality reporting is evolving, and accountable care organizations are at the forefront of this change. In 2025, ACOs will be required to shift from traditional quality reporting via the CMS Web Interface to eCQMs, marking a significant transition in their reporting process.
By Peter Bresler – Health systems are pursuing digital initiatives to meet their unprecedented financial and strategic challenges. These initiatives include the creation of a modern consumer-grade experience, automating myriad back office processes, and delivering care using virtual technologies.