Tag: private payer prices

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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CMS takeover of 340B looms as some health systems double down on drug discount strategy

Editor's Note The federal 340B Drug Pricing Program may soon shift from the Health Resources and Services Administration (HRSA) to the Centers for Medicare and Medicaid Services (CMS), a move that could bring tighter oversight and lasting consequences for safety-net providers, Modern Healthcare June 2 reports. The proposed transfer, part…

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By: Tarsilla Moura
June 3, 2025
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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…

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By: Matt Danford
March 31, 2025
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Session: Course Correction—Negotiating Payor Rates in the ASC Setting

Editor's Note Negotiating pay rates in the ambulatory surgery center (ASC) setting is a complex and evolving process that requires strategic planning, data-driven decision-making, and strong payer relationships, noted the speakers Amy Coletti, principal, ASC practice, and Matt Kilton, partner, at ECG Management Consultants at this year’s OR Business Management…

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By: Tarsilla Moura
February 12, 2025
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Podcast episode discusses the anesthesia provider shortage in ASCs

Editor's Note In a January 9 episode of the Advancing Surgical Care Podcast, ASCA President Mark Wainner engaged Alfonso del Granado, MBA, FACHE, CASC, an ASCA Board member and administrator of Covenant High Plains Surgery Center in Lubbock, Texas, in a discussion focusing on the pressing issue of anesthesia provider…

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By: Tarsilla Moura
January 22, 2025
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RAND study reveals private payers pay 250% more than Medicare for healthcare services

Editor's Note A recent analysis by the RAND Corporation, a research and analysis nonprofit, revealed a disparity between hospital and ambulatory surgery center (ASC) prices paid by employers and private payers compared to Medicare prices, Revcycle Intelligence May 15 reports. The study, covering data from 2020 to 2022, showed private…

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By: Tarsilla Moura
May 22, 2024
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