About one in five in-network claims were denied by insurers of qualified health plans on HealthCare.gov in 2023, according to KFF. There is also wide variation by insurer and state.
This year’s ACA Marketplace enrollment represents a 13% increase, or 1.8 million people, from last year, according to CMS. There were more than 12.7 million returning consumers and more than 3.6 million new consumers.
Transitioning to PDPM models significantly shifted the healthcare industry. By replacing the RUG system, healthcare providers cut waste and more accurately reflect the care each patient received.
With a new nominee as the Supreme Court prepares to hear a case that could determine the future of the Affordable Care Act, the health law’s future has been thrown into question. According to the Robert Wood Johnson Foundation, the number of uninsured could increase by 70% if the ACA is overturned.
With many U.S. residents getting health insurance through their company, millions of newly unemployed will be seeking coverage. But those that lived in states without Medicaid expansion, or who already lacked insurance, may struggle to find coverage.
The Centers for Medicare and Medicaid Service released final federal open enrollment numbers on Wednesday. Nearly 8.3 million people signed up for plans on HealthCare.gov, a slight dip from last year.
Rolling out the ratings nationwide is part of the Trump Administration's larger initiative to inject cost and quality transparency into the healthcare system.
A new report from Relatient, A Data-Driven Guide to Patient Access Succes, highlights how focusing on data accuracy and relevance can enhance the performance of healthcare practices.
Critics say the Trump administration is intentionally undermining ACA, through regulatory actions. It shortened the enrollment period, withdrew money for advertising and cut the budget for navigator groups, which help people shop for plans.
Actor/comedian Colton Dunn, of "Superstore" on NBC, has picked up the slack, posting a series of low-budget but effective videos as alternative ads for HealthCare.gov.
The new tool will designate marketplace health plan networks as “basic,” “standard” or “broad” based on how they compare with other health plan networks in a county.
Also, Aetna employees get financial incentives to get a good night's sleep and Hackensack University Medical Center has partnered with Uber to smooth the discharge process.
Patient expectations continue to evolve, and healthcare practices that fail to adapt risk more than just revenue—they risk losing trust.
"Fetishizing phones above every other value can't be the right answer."
“We just want to be sure that people understand what they’re buying and understand the limitations of these plans,” says Anna Howard, a policy principal at the American Cancer Society Cancer Action Network.
A report by the government accountability office showed that the federal marketplace is vulnerable to fraud, a physical therapy startup could be next telemedicine IPO.
Andy Slavitt, who has served as acting administrator of the Centers for Medicare and Medicaid Services since the beginning of March, has been nominated to be permanent head of the agency. Already, some key Republicans have expressed concern because of Slavitt's ties to the troubled HealthCare.gov insurance marketplace, a symbol of GOP opposition to the Affordable Care Act.
When terms like coinsurance, deductible or premium tax credit are practically meaningless to young people, how can they sufficiently navigate their options?