Tag: health insurance

HFMA warns affordability crisis is driving up provider bad debt

Editor's Note According to a Healthcare Financial Management Association (HFMA) analysis, the US healthcare system is in “serious condition,” with affordability collapsing and provider financial risk escalating, HealthLeaders September 19 reports. The group’s new Healthcare Vitals Tracker scored the industry just 35.9 out of 100, compared to a peak of…

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By: Tarsilla Moura
September 24, 2025
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Outpatient artificial disc replacement proves safe, efficient, game-changing for spine surgery

Editor's Note Artificial disc replacement (ADR) no longer requires a hospital stay. In one of the largest analyses to date, a California surgical team reviewed 1,043 outpatient ADR cases over 6 years and found zero immediate hospital transfers, zero transfusions, and every patient discharged home in under 24 hours, LA…

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By: Tarsilla Moura
September 16, 2025
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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…

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By: Matt Danford
July 16, 2025
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Study: Racial, insurance disparities persist in access to buprenorphine after opioid-related events

JAMA (healthcare publication) Network logo

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…

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By: Matt Danford
July 2, 2025
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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…

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By: Tarsilla Moura
June 25, 2025
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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…

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By: Matt Danford
June 25, 2025
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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…

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By: Matt Danford
June 23, 2025
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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…

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By: Matt Danford
June 20, 2025
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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…

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By: Matt Danford
June 16, 2025
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CMS vision shifts as agency halts funding for state programs

Centers for Medicare & Medicaid Services

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…

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By: Matt Danford
April 11, 2025
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