Inpatient psychiatric facilities are spending a significant proportion of their average revenue on compliance with basic conditions of participation for Medicare, according to a new report from the...
Privately insured patients transported by emergency air ambulances outside their coverage networks are at high risk of balance billing, also known as surprise billing, according to a GAO report.
Just...
Health plans are asking Congress to take swift action on surprise billing, which can leave consumers with enormous out-of-pocket expenses for unexpected or out-of-network services.
In a letter to...
Blue Shield of California’s Narcotic Safety Initiative has achieved a 56 percent reduction in opioid use among members with chronic pain, surpassing its 2018 year-end goal by six percentage...
Cambia Health Solutions has partnered with two healthcare provider networks to enhance health data exchange by leveraging FHIR.
As part of the Da Vinci Project, Cambia is working with Oregon Health...
The House Energy & Commerce Committee (E&C) has opened an inquiry into short-term limited duration insurance (STLDI) plans and companies that may be acting against consumer interests by selling...
Net prescription drug spending increased from $250.7 billion in 2012 to $341 billion in 2016, according to a new report from the Pew Charitable Trusts.
The report also found that over the same period,...
Physicians are still frustrated by problematic prior authorization (PA) procedures and believe that health payers are moving too slowly on necessary solutions, finds a new survey by the American...
Cambia Health Solutions and Blue Cross of North Carolina have announced a new strategic affiliation that will combine management operations into a single entity retaining the Cambia name.
The two...
State and federal policymakers are still considering various approaches to solve surprise billing issues and compensate out-of-network providers, including mandated values for reimbursement and...
A federal court has found that United Behavioral Health (UBH), a unit owned by UnitedHealth Group, used a flawed methodology to deny mental health and substance abuse treatment services to...
CMS is soliciting public comments on strategies that would allow enrollees to purchase health insurance across state lines in an effort to increase competition and improve affordability for...
Consumers are turning to short-term health plans primarily because they cannot afford other options, according to a new survey from insurance portal eHealth.com.
Instead of using short-term plans to...
National healthcare expenditures are expected to grow at an average of 5.5 percent annually from 2018 to 2027, reaching $6.0 trillion by 2027, according to a report from the Office of the Actuary at...
Non-US citizens, including immigrants lawfully present in the country, are significantly more likely than citizens to be uninsured, according to new data from the Kaiser Family Foundation (KFF).
The...
State legislators in Vermont and North Carolina are considering legislation that would impact the viability of association health plans (AHPs) in their states.
State bills in Vermont and North...
Premier Inc. is projecting a 3.8 percent rate of inflation for prescription drug prices in plan year 2020, with non-acute care items comprising the majority of price increases.
While price increases...
Major health payers and representative trade groups are urging CMS not to eliminate the practice of silver-loading, which has been used to stabilize premiums in a volatile and unpredictable market.
In...
Seventy-one percent of employers with 100 or more employees are either actively integrating or considering integrating their medical, dental, vision, and pharmacy benefits under their health and...
Cigna and Sentara Healthcare have joined a new healthcare-focused collaborative that aims to build, share, and deploy solutions using blockchain technology.
The collaborative also includes Aetna,...
