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Providers warn of another decade of 340B payment problems
1+ week, 6+ day ago (779+ words) The American Hospital Association is warning the federal government that history could repeat itself if it finalizes reimbursement cuts to hospitals participating in the 340B Drug Pricing Program. In July, the Centers for Medicare and Medicaid Services proposed significantly cutting reimbursement…...
How employers are rethinking benefits as healthcare costs soar
2+ week, 4+ day ago (806+ words) The data is clear: Employers are facing nearly double-digit healthcare cost growth next year. This new reality is prompting them to rethink their benefits strategies and partnerships, according to a survey by the Business Group on Health. The nonprofit organization…...
Hospital rate caps could slash health costs by $1T over a decade
2+ week, 4+ day ago (749+ words) As the U.S. grapples with exorbitantly high healthcare costs, a new study suggests capping hospital rates could reduce overall spending by hundreds of billions of dollars. The U.S. spent $5.7 trillion on healthcare last year, federal actuaries reported in June. This marked the…...
Hospitals feel payer mix shifts as uncompensated care costs grow
2+ week, 5+ day ago (743+ words) AndreyPopov/istock via Getty Ima Hospitals are already seeing uncompensated care costs swell as the U.S. faces a major shift in healthcare coverage, according to new hospital financial performance data. The data from Kaufman Hall, a Vizient company, shows that bad…...
Employee health benefits to spike 9.5% in 2027
2+ week, 6+ day ago (520+ words) AndreyPopov/istock via Getty Ima Employers can expect to pay 9.5% more for employee health benefits in 2027, with new reporting from professional services firm Aon projecting average employee healthcare costs totaling more than $19,000 in the coming year. These numbers reflect the…...
Payers say AI doesn't deny care. The truth is more complex.
2+ week, 5+ day ago (1197+ words) ipopba/istock via Getty Images Artificial intelligence does not determine whether care is approved or denied, UnitedHealth Group's Chief Financial Officer Wayne DeVeydt told reporters at the company's second quarter earnings call in July. This is a sentiment echoed by…...
Survey: Front-end workflows to blame for most claim denials
3+ week, 3+ day ago (593+ words) A recent national survey found that claims denials are a leading revenue cycle challenge for nearly three-quarters of healthcare organizations, with front-end workflows contributing the most to reimbursement breakdowns. Claim denials narrowly beat patient payment collection as the top overall…...
How providers can weather Medicaid cuts when many won't
3+ week, 3+ day ago (1417+ words) Recent Medicaid and Affordable Care Act changes will have a widespread impact on healthcare providers, whether they work for large health systems or small ambulatory practices. However, some types of providers stand to lose more than others, and the effects…...
Appeals court overturns No Surprises Act QPA calculation method
4+ week, 2+ day ago (657+ words) In a major win for healthcare providers, a U.S. appeals court ruled against the federal government's formula for calculating qualifying payment amounts under the No Surprises Act. The ruling released on Tuesday tossed aside two key factors insurers use to determine…...
Employers eye ICHRAs, but affordability remains a concern
1+ mon, 1+ week ago (532+ words) Employers are increasingly considering Individual Coverage Health Reimbursement Arrangements, or ICHRAs, for their workers' health insurance, though knowledge gaps could dampen adoption, according to a recent survey from the Employee Benefit Research Institute and Morgan Health. More than one-third of…...