Medicare Advantage Insurers Hold Sway Over More Hospital Admissions
Forbes Healthcare
JULY 24, 2024
Medicare Advantage is accounting for “a rising share of inpatient hospital days,” according to a new KFF study shows.
Have Good Health Insurance? Too Bad. You Could Still Get A $250,000 Bill
Forbes Healthcare
JUNE 13, 2024
The bureaucracy and opacity of hospital and insurance billing is impossible to navigate. But it doesn't have to be.
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Hospital Threatens to Deport Comatose Mother for Undocumented Status
Scrubs
MARCH 8, 2023
A comatose patient at Lehigh Valley Network’s Cedar Crest Hospital in Pittsburg, PA may soon be on her way to the Dominican Republic despite her family wanting to keep her in the U.S. Rivas said his wife’s care went downhill once the hospital found out about their immigration status.
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Almost One-Third of Rural Hospitals Benefiting from Microsoft’s Cybersecurity for Rural Hospitals Program
The HIPAA Journal
MARCH 26, 2025
If the nearest hospital experiences a ransomware attack that causes disruption to hospital operations, rural residents must travel a further 20 miles for common services and often a further 40 miles for specialized services. In 2022, 429 rural hospitals were at high financial risk.
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Maine Hospital Using AI to Record Patient Conversations
Scrubs
MARCH 21, 2023
Deborah Vaughan, a patient at the hospital, said she appreciates being able to look her doctor in the eye while talking about her health. Nobody went into medicine to write notes or fill out insurance authorization forms,” said J. Scott Smitherman, chief medical information officer at Providence Health.
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Hospitals charge private insurers more than double Medicare rates, RAND report finds
Medical Economics
MAY 14, 2024
Study shows private insurers paid hospitals an average of 254% of what Medicare would have paid
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The Craziest Medical Bills
Scrubs
AUGUST 11, 2023
trillion, was spent on hospital services. Patients around the country are getting stuck with enormous medical bills as hospitals continue to mark up the cost of their services, including those for routine medical procedures and advanced surgeries. Overall, she spent a month in the hospital recovering from surgery.
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Outpatient is the New Inpatient – The Future of Hospitals in America
Health Populi
FEBRUARY 26, 2020
hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? Our ability to create that network outside the hospital is huge.”
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US healthcare is headed for disaster
Sensible Medicine
NOVEMBER 30, 2023
Second, Medicare has agreed to pay for GRAIL cancer screening as part of coverage with evidence development and third, many doctors protested Cigna’s denial of coverage for a double lung transplant for stage IV lung cancer, leading the insurer to agree to cover it. How are these three things linked? Here are some examples.
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Hospitals could face revenue hit if insurers play hardball over MA: report
Healthcare Dive - Practice Management
MARCH 21, 2024
Insurers could increase claims denials and engage in aggressive contract negotiations with hospitals as profitability in the popular plans declines.
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Why shadowing Vinay Prasad convinced me to become an oncologist
Sensible Medicine
MARCH 19, 2025
Our day began at the outpatient clinic of the UCSF’s San Francisco General Hospital. At 12:00, we crossed the street to enter the inpatient part of the hospital. He doubted that the hospital would allow us to prescribe such a costly drug. To me, it was a glimpse into the sheer size and scope of the hospital machine.
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Hospitals charged employers and insurers 254% more than Medicare in 2022: study
Healthcare Dive - Practice Management
MAY 14, 2024
Hospitals with larger market shares were among the worst offenders, the RAND Corporation found.
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$22,789 For Appendicitis. And I Didn’t Even Have Surgery
Forbes Healthcare
JULY 30, 2024
Hospital charges in the United States are astronomical. Lack of regulation, the structure of our insurance system, and excessive inefficiency are reasons why.
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A Complete Guide to Medical Insurance Credentialing
CollaborateMD
MARCH 20, 2025
Whether you’re a physician starting a practice or a healthcare provider working to expand patient access, getting medical insurance credentialing is vital. RELATED ARTICLE: Optimizing Insurance Payer Reimbursement with RCM Services What is Medical Insurance Credentialing? Let’s dive in.
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One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy
Health Populi
JUNE 18, 2021
with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. One in two people in the U.S. One-half of U.S. One-half of U.S.
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Breaking point: Why practices can’t bear the National Insurance hike
Practice Index
NOVEMBER 7, 2024
The bombshell dropped by Rachel Reeves in last week’s budget regarding the increase in National Insurance contributions (NICs), without exempting GP practices, has been described as a monumental body blow to the heart of the NHS. To treat us like any other private company is just ignoring what we actually do.”
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U.S. Hospitals Will Lose $323 Billion in 2020 – Before Accounting for Growing COVID Cases
Health Populi
JULY 1, 2020
health systems are projected to lose $323 billion in 2020 due to declining inpatient and outpatient volumes caused by the COVID-19 pandemic’s impact on the “normal” hospital business. Hospitals racked up over $200 bn in losses between March and June 2020. leading to growing un- and under-insured people).
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Data Breaches Reported by Mystic Valley Elder Services & St. Anthony Regional Hospital
The HIPAA Journal
OCTOBER 31, 2024
The data involved varied from individual to individual and may have included names, dates of birth, passport numbers, financial account numbers, payment card numbers, online credentials, taxpayer identification numbers, Social Security numbers, driver’s license numbers, health insurance information, and medical information.
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Yes, we should definitely study that!
Sensible Medicine
JULY 29, 2024
Yet the failure of the hospital readmission penalty policy and sepsis protocols expose the risks of implementing a policy because it sounds good. He cites the Rand , Oregon and Indian health insurance studies, which all find little to no effect of giving health insurance to people. Yet policies mostly escape this challenge.
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Hospitals with the Most Vulnerable Maternity Patients Understaffed with Nurses
Minority Nurse
MAY 19, 2023
Hospitals serving more patients at risk for complications during childbirth are less likely to have enough nurses to care for patients during labor, delivery, and recovery, according to a new study in Nursing Outlook. for the most vulnerable childbearing populations, including Black mothers and those insured by Medicaid.
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The Ill Health of Rural Hospitals in Four Charts
Health Populi
FEBRUARY 18, 2020
There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years.
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Across Healthcare System, Stakeholders Share Responsibility For High Costs
Forbes Healthcare
FEBRUARY 11, 2025
This includes hospitals, drugmakers, insurers and others involved in product and service supply chains. Across healthcare system, stakeholders share blame for high costs.
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Nursing: 5 things I wish I knew when I graduated
Scrubs
JULY 22, 2023
Pay for personal liability insurance. Protect your assets and your license by having personal liability insurance separate from anything offered to you through your employer. You need separate insurance because it is possible that your employer could sue you, and in that case, their liability insurance would probably not cover you.
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Beacon Health System Affected by Two Business Associate Email Breaches
The HIPAA Journal
MARCH 28, 2025
The account was reviewed, and on January 24, 2025, it was confirmed that emails in the account contained the protected health information of patients of Beacon Health Systems Three Rivers Health Hospital in Michigan. This incident occurred at the business associate Restorix, which provides hospitals with wound care services.
The Return of American Manufacturing Demands a Chief Health & Benefits Officer (CHBO) to Fix Benefits Procurement
The Healthcare Blog
MARCH 26, 2025
Ballooning insurance premiums bloated administrative costs, and an opaque, middleman-driven system have left businesses with the highest healthcare costs in the worldtwice as much as top global competitors. Companies can no longer blindly trust big insurance carriers or PBMs to act in their best interest. For decades, U.S.
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This Entrepreneur Is Helping Cancer Patients Find Accurate Treatment By Analyzing Images With AI
Forbes Healthcare
NOVEMBER 27, 2024
Patients can now access the test with their physicians at 20 hospitals around the nation and get reimbursed by their insurance companies. A study of more than a thousand bladder cancer patients found that Valar's first AItest, called Vesta, was able to accurately determine whether a typical treatment would be effective.
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Endue Software Confirms Data Breach Affecting Multiple Providers
The HIPAA Journal
APRIL 29, 2025
Cybersecurity incidents have been announced by Endue Software, Whitman County Public Hospital District No. 3, Palo Verde Hospital, and Northern California Children’s Therapy Center. Whitman County Public Hospital District No. 3 Whitman County Public Hospital District No. Whitman County Public Hospital District No.
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Washington to the Rescue: Help to Hospitals in Wake of Cyberattack
Coronis Health
MARCH 13, 2024
The agency has been in constant communication with Change Healthcare and its parent company, UnitedHealth Group, since the company revealed the details of the attack and its attendant disruptions in downline processes, including interruptions in the payment of medical claims by multiple insurance plans and programs.
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Cyberattack Forces North Carolina Radiology Practice to Close for More Than a Month
The HIPAA Journal
MARCH 19, 2025
Security incidents and data breaches have been reported by Baylor Scott & White Texas Spine & Joint Hospital and Atlas Healthcare CT. Baylor Scott & White Texas Spine & Joint Hospital Baylor Scott & White Texas Spine & Joint Hospital has identified a breach of its Microsoft Office 365 environment.
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U.S. Health Care in 2025 Requires Scenario Planning: The Uncertainties That Inspire DIY Healthcare
Health Populi
APRIL 14, 2025
To the far right we see the longer-term cycle where consumers take over for the intermediaries who were the middle-actors between patients-as-consumers and health care industry stakeholders– whether pharmas and PBMs, physicians and hospital systems, health plans, and other sources of care, supplies, and financing.
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Work Environments for a Medical Billing & Coding Specialist
Northwest Career College
OCTOBER 28, 2024
Many healthcare settings require the services of medical billing and coding specialists for record organization and management, insurance claims, and billing. State, Local, and Private Hospitals Hospitals are the biggest employers of medical billing and coding specialists. Professional development opportunities.
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The Thematic Roadmap for AHIP 2024: What the Health Insurance Conference Will Cover
Health Populi
JUNE 10, 2024
Health insurance plans make mainstream media news every week, whether coverage deals with the cost of a plan, the cost of out-of-network care, prior authorizations, or cybersecurity and ransomware attacks, among other front-page issues. Embracing workforce well-being — in and outside of health care.
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Trust My Doctor and Fear the Office: The Telehealth Opportunity in and Beyond the COVID-19 Pandemic
Health Populi
MAY 21, 2020
42% felt uncomfortable going to a hospital for any medical treatment. Nearly every respondent in the study reported having health insurance coverage. Among those covered with insurance, one-half had employer-sponsored insurance, 1 in 4 Medicare, and 13%, individual cover. ACHP and AMCP polled 1,263 U.S.
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Addressing Health Equity Must Include Digital Equity Beyond Access To Medical Services and Insurance
Health Populi
JUNE 5, 2020
Three physicians from Brigham and Women’s Hospital, part of Harvard Medical School, cite three pillars that underpin digital health inequity in America: Technology access barriers, Digital health literacy, and. Lack of inclusive design.
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Consumers Rank Healthcare Experiences in the Bottom-Third of All Industries – the ACSI 2021-2022 Index
Health Populi
NOVEMBER 1, 2022
While consumers’ satisfaction with inpatient care experiences improved a few points over the past year, health insurance and hospitals still fall in the bottom-third of all industries with which people interact, according to the American Customer Satisfaction Index (ACSI) Insurance and Health Care Study 2021-2022.
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Vitruvian Health & Erlanger Health Affected by Nationwide Recovery Service Cyberattack
The HIPAA Journal
APRIL 18, 2025
Cyberattacks have also been reported by Howard Memorial Hospital and Boudreauxs Specialty Compounding Pharmacy. Erlanger Health said 3,193 individuals have been affected by the breach, all of whom had previously received services from Erlanger Western Carolina Hospital.
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Health insurers are ignoring price transparency rules at the expense of private practice
KevinMD.com
MAY 17, 2024
Since January 1, 2023, the Transparency in Coverage Rule required health insurance providers and health insurers to provide price information to participants in a publicly accessible place.
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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity
Health Populi
FEBRUARY 27, 2024
That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).
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Will Trade Data for (Cheaper) Health Care – USC’s View of the Future
Health Populi
FEBRUARY 20, 2020
As such, American health consumers are wrestling with sticker shock from surgical procedures, surprise medical bills weeks after leaving the hospital, and the cost of prescription drugs — whether six-figure oncology therapies or essential medicines like insulin and EpiPens. Patients are now front-line payors in the U.S. health care system.
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6 Ways ER and Urgent Care Nurses Can Bridge the Gap for Uninsured Patients
Scrubs
MAY 18, 2024
Nurses in these settings play a pivotal role in providing medical care and guiding patients through the complexities of the healthcare system without insurance. Nurses can be crucial navigators by providing information on hospital financial assistance programs and flexible payment plans.
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Judge strikes down FTC noncompete ban nationwide
Healthcare Dive - Practice Management
AUGUST 21, 2024
healthcare, an industry that frequently relies on noncompetes to lock medical workers into employment agreements with hospitals, insurers and other employers. Obviating the ban has big implications for U.S.
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Mercer County Joint Township Community Hospital Cyberattack Affects Up to 88,500 Individuals
The HIPAA Journal
APRIL 4, 2025
Mercer County Joint Township Community Hospital in Coldwater, Ohio, has suffered a significant data breach involving the electronic protected health information of up to 88,541 individuals. The post Mercer County Joint Township Community Hospital Cyberattack Affects Up to 88,500 Individuals appeared first on The HIPAA Journal.
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Premiums for ACA plans to grow 7% next year: KFF
Healthcare Dive - Practice Management
AUGUST 7, 2024
Insurers cited workforce shortages, hospital consolidation and growing demand for pricey GLP-1 drugs as reasons driving the premium increases for 2025.
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Patients, Nurses and Doctors Blame Health Insurers for Increasing Costs and Barriers to Care
Health Populi
JULY 17, 2023
Most patients, nurses and doctors believe that health insurance plans reduce access to health care which contributes to clinician burnout and increases costs, based on three surveys conducted by Morning Consult for the American Hospital Association (AHA). We must shift our True North mantra for improving health care in the U.S.
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