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CMS encouraging states to use Medicaid payments to nursing homes to improve outcomes
In support of the administration’s plan to improve the nation’s nursing homes, the Centers for Medicare and Medicaid Services has issued an informational bulletin detailing actions that states can take using existing Medicaid authorities to drive bette…
U.S. employer healthcare costs projected to increase 6.5% in 2023
Average costs for U.S. employers that pay for their employees’ healthcare will increase 6.5% to more than $13,800 per employee in 2023, largely due to economic inflation pressures, according to professional services firm Aon.
This projection is more th…
Insurers may be violating No Surprises Act over Qualified Payment Amounts
In possible violation of the No Surprises Act, health insurance company calculations of Qualified Payment Amounts for anesthesiology, emergency medicine and radiology services – and possibly other specialty services – likely include rates from primary …
Medicare Advantage lacking for mental health coverage
Overall customer satisfaction with Medicare Advantage plans has increased this year, thanks largely to improvements in billing and payments, cost and provider choice. But according to the new J.D. Power 2022 U.S. Medicare Advantage Study, some concerni…
Nonprofit hospitals’ outlook downgraded to ‘deteriorating’ by Fitch
Due to labor and other macro inflationary pressures, Fitch Ratings has revised its outlook for nonprofit hospitals and health systems to “deteriorating.”
High out-of-pocket costs are negatively affecting revenue cycles
In art and photography, the “vanishing point” is the point at which two lines converge, meeting at the horizon line and suggesting three-dimensional space. In hospital revenue cycles, the vanishing point is $7,500.
Managing costs, operational efficiencies top challenges for payers
In 2021, the pace of change in the healthcare industry picked up dramatically, with the introduction of new regulatory requirements, rising expectations among consumers, new competitive threats and the shift toward value-based payment strategies. This …
UnitedHealthcare seeks to remove deductibles with Surest offering
UnitedHealthcare is making a push to remove deductibles and provide clear, upfront pricing information with its new Surest offering, itself a rebrand of Bind, which was introduced in 2016. According to UHC, Surest has the fastest growth rate among its …
Labor shortage, inflation contribute to Mass General Brigham’s $949M net loss
Significant financial pressures, including a widespread labor shortage, cost inflation and the enduring capacity crisis, have contributed to a rough financial quarter for Mass General Brigham, which saw a $949 million net loss and -2.8% operating margi…
