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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…...
Health plans fall short in maternity care member communication
1+ mon, 4+ week ago (815+ words) Health plans and their pregnant members might agree that member communication is a priority, but they aren't on the same page about what good communication actually looks like, according to a new report from Sage Growth Partners. Member communication, particularly…...
Care continues shift to outpatient as hospital margins dip
1+ mon, 4+ week ago (719+ words) Where hospital care happens is fundamentally shifting, according to the latest hospital financial performance data from Kaufman Hall. The healthcare consulting firm released its monthly National Hospital Flash Report yesterday, drawing on data from more than 1,300 hospitals. In addition to…...
Can Costco hack Medicare Advantage's consumer loyalty problems?
3+ week, 2+ day ago (945+ words) A new partnership with California-based payer SCAN Health Plan marks Costco's first step into the Medicare Advantage market, as the wholesaler unveiled new branded health insurance plans this week. The deal is scant on details so far, but SCAN did…...
State-based subsidies saved some ACA Marketplace losses
1+ mon, 2+ week ago (825+ words) A new report from KFF outlines effectuated Affordable Care Act Marketplace enrollment, painting what the organization says is a clearer picture of how overall ACA coverage has changed this year. The analysis comes after previous reporting that ACA Marketplace signups…...
Payers say AI doesn't deny care. The truth is more complex.
2+ week, 5+ day ago (1197+ words) according to Stacie Sutter, vice president of payer strategy at Ensemble Health Partners, a revenue cycle management...
How employers are rethinking benefits as healthcare costs soar
2+ week, 4+ day ago (806+ words) uncomfortable disrupting their current benefit strategy to improve the quality of care and/or lower costs....said they will implement at least one value-based strategy next year, with centers of excellence being the...they are considering an outcome-based pricing strategy…...
AdaptHealth says hackers exfiltrated patient data in social engineering attack
2+ mon, 4+ day ago (254+ words) Vitalii Gulenok/istock via Getty AdaptHealth, a nationwide supplier of home medical equipment, disclosed a data breach that impacted an undetermined number of patients, according to a Form 8-K filing with the U.S. Securities and Exchange Commission. The company partners with…...
HHS cut 3M ACA Marketplace enrollments in ongoing fraud efforts
2+ mon, 2+ week ago (453+ words) A new HHS report contends the Trump Administration has rooted out nearly 3 million fraudulent Affordable Care Act Marketplace enrollments. Still, the agency estimates there are 2.6 million "improper or phantom enrollments" remaining on the Marketplace. The report, prepared by the HHS…...
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…...