A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Category: Health Insurance
Trends 2025: The demand for interim revenue cycle executives
The search for revenue cycle management leaders is ongoing and can be particularly challenging because of the nature of the executives who take on the job, according to one expert.
“These leaders often have a fix-it mentally,” according to Adam Burns, …
Advocate spending $1 billion on new hospital and outpatient services
Chicago-based Advocate Health Care is planning to spend $1 billion to improve access to primary and specialty care, as well as wellness services, by investing in a new hospital and extended outpatient programs.
The investment will improve access to pri…
Employers Press Congress To Cement Health Price Transparency Before Trump’s Return
Donald Trump’s first administration advanced rules forcing hospitals and insurers to reveal prices for medical services. Employers don’t want to risk backtracking during Trump’s second administration.
Male physicians have more net worth than female counterparts
Wealth and earnings disparities between men and women are nothing new, but a new report from Medscape shows the extent to which this is true in healthcare, showing that 66% of male physicians had a family net worth of more than $1 million last year – c…
CMS ending VBID model due to high costs
The Centers for Medicare and Medicaid Services is terminating the Medicare Advantage Value-Based Insurance Design (VBID) model at the end of 2025 due to what it called the model’s “substantial and unmitigable costs to the Medicare Trust Funds.”
How Medicare Negotiated Drug Prices Compare to Other Countries
This analysis finds that Medicare’s negotiated prices for 10 high-expenditure prescription drugs are lower than what private Medicare drug plans had been paying, but still much higher than the prices available in 11 other wealthy nations.. It is availa…
Obamacare Sign-Ups Lag After Trump Election, Legal Challenges
The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.
He Went in for a Colonoscopy. The Hospital Charged $19,000 for Two.
A man in Chicago with a troubling symptom underwent a common procedure. Then he wanted to know why the hospital charged nearly three times its own cost estimate.
Healthcare expenditures rise on increased coverage and utilization
Healthcare spending is higher than before the pandemic and is being driven by increases in insurance coverage and utilization, according to new analysis released Wednesday by the Office of the Actuary at the Centers for Medicare and Medicaid Services a…
