Five underreported health changes in 'big beautiful bill'
Editor's Note Although the newly enacted One Big Beautiful Bill Act is best known for major Medicaid cuts and a temporary Medicare Physician Fee Schedule increase, it also carries significant policy changes that could affect providers, patients, and the physician workforce, MedPage Today reported July 11. The article lists five…
Study: Racial, insurance disparities persist in access to buprenorphine after opioid-related events
Editor's Note Black and Hispanic patients remain significantly less likely than White patients to receive buprenorphine after an opioid-related health care event, according research published June 26 in JAMA Network Open. Patients with Medicaid or Medicare Advantage also had higher odds of receiving buprenorphine than those with commercial insurance. The…
DOJ task force, insurers target ASC barriers with parallel reforms
Editor's Note Federal regulators and major insurers are independently moving to ease long-standing burdens on ambulatory surgery centers (ASCs), potentially reshaping the regulatory and administrative landscape in which perioperative leaders operate. According to Ambulatory Surgery Center News June 23, ASC stakeholders are actively engaging with the new Anticompetitive Regulations Task…
Major insurers pledge prior authorization reform
Editor's Note Nearly 50 major US health insurers—including UnitedHealthcare, Aetna, Cigna, Elevance, and Humana—have pledged to reform prior authorization practices, with the goal of easing administrative burdens and improving access to care, according to a June 23 article in Healthcare Dive. As detailed in the article, the announcement came from…
Bad debt climbs as patient defaults, denials impact hospital revenue growth
Editor's Note Bad debt—payments hospitals expected to collect but ultimately had to write off—is increasing across hospitals as patients struggle to pay their share of healthcare costs and insurers raise the rate of claim denials, Modern Healthcare reported June 19. Citing a Kaufman Hall analysis of data from about 700…
Tariffs stir uncertainty in hospital supply chains, health insurance premiums
Editor's Note Recent reporting from Axios reveals hospitals and health insurers are reporting new concerns about rising tariffs and trade policy uncertainty, with the former delaying purchasing decisions and the latter planning premium increases as a result. In the first article, published June 18, the outlet reports that health system…
Low-income patients face uphill battle overturning insurance claim denials, study shows
Editor's Note Patients earning less than $50,000 annually are significantly less likely to have denied insurance claims reversed compared to wealthier individuals, according to a new study published in Health Affairs and reported by Fierce Healthcare on June 5. Researchers from the University of Massachusetts Amherst and the University of…
CMS vision shifts as agency halts funding for state programs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) will no longer approve federal matching funds for designated state health programs (DSHPs) and designated state investment programs (DSIPs) that are not directly related to Medicaid services. According to the April 10 announcement, the decision aims to preserve the core…
Renewed push for healthcare price transparency faces familiar challenges
Editor's Note Although a recent executive order from President Donald Trump aims to make hospitals and insurers reveal negotiated prices, data inconsistencies and a lack of consumer usability continue to hinder progress, according to a March 31 article from NPR. As detailed in the report, the executive order builds on…
Rethinking life after 65: A three-pillar approach to retirement planning
Editor's Note With several major gatherings planned for this spring—including those from AORN, AONL, ASCA, and ASPAN—a bustling events season offers perioperative leaders valuable opportunities for reflection on our careers and futures. Speaking of futures, the 2024 OR Manager Salary/Career Survey revealed an intriguing shift: only 9% of perioperative nurses…
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