A Four-Part Roadmap for Responsible Prior Authorization
The tools exist today to significantly reduce PA's burden on our healthcare system, we just need to mobilize and implement them.
How Health Insurers Are Embracing Technology to Serve Real People
The time to innovate is now. By embracing transformative solutions, insurers and employers can not only address systemic challenges but also create a future where healthcare is equitable and sustainable.
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Why Workflow Chaos Is Undermining Care – and What Providers Can Do About It.
Healthcare is drowning in chaos—from scattered data to burnout-inducing tasks. Discover how smarter workflows and real-time insights can rescue care teams and transform patient outcomes.
Zero-Sum Game: The Current Healthcare System Is Reaching a Breaking Point
It’s tragic that it takes a shooter, aggravated by his back pain and frustrated with the healthcare system, to spark a necessary conversation about healthcare.
Will A Second Trump Term be a Financing Boon for Healthcare?
The impact of private equity investments in healthcare under the new administration is multifaceted. While deregulation and business-friendly policies could stimulate investment and drive innovation, there are significant concerns about the potential negative effects on healthcare quality and access.
FDA Commissioner: Insurers Need To Support Studies In Accelerated Drug Approval Pathway
Physicians face a lot of barriers from insurers in completing studies on drugs in the accelerated approval pathway, declared Dr. Robert Califf, commissioner of food and drugs at the Food and Drug Administration. Insurers need to help, he said during the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum.
Leapfrog: Employers Give Health Plans a ‘C’ Letter Grade
A survey from The Leapfrog Group asked employers to give their health plans an "A" through "F" letter grade. From those letter grades, Leapfrog calculated the health plans’ average Grade Point Average (GPA) on a 4.0 scale. Health plans received a 2.29 GPA in 2022, a slight decrease from Leapfrog’s prior survey in 2020, which had a 2.57 GPA.
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The Top 5 Home Care Franchise Opportunities in the U.S.
The home care industry is booming. As Baby Boomers age and more families seek in-home solutions for loved ones, demand for home care services is at an all-time high.
Americans Are Confused With Their Medical Bills. Here’s How the Healthcare Industry Can Help
Nearly 40% of Americans struggle understanding their medical bills, a recent survey showed. But receiving more communication and support from providers and insurers would make bills less confusing, the respondents shared.
Report: Health Plans Need To Do Better When It Comes to Care Navigation
About 62% of Americans don’t trust their health plan when it comes to finding care, a Ribbon Health survey found. Providing more accurate information on provider directories could repair this trust.
Consumers Need Better Communication From Their Health Plans, Survey Shows
More than half, or 58%, of health plan members are “overwhelmed” when it comes to managing their health plans. Insurers need to provide information in a way that's accessible and easy to understand, the report stated.
Report: Insurers from 55 countries expect healthcare benefit costs to jump 10% in 2023
The 10% increase is the largest in almost 15 years, the Willis Towers Watson survey found. Most of the insurers, or 75%, blamed the overuse of care for the rise in medical costs.
Solving Healthcare’s Provider Data Problem Starts with Interoperability
Break down the silos. Take control of your provider data.
What insurers’ premium rate filings can tell us about predicted health utilization in 2022
An examination of health insurers' premium rate filings for 2022 shows that most are not factoring in additional costs or savings, which indicates that they expect health utilization to reach pre-pandemic levels.
Bright Health follows rival Oscar Health down IPO path
Bright Health has filed preliminary paperwork for an IPO, joining its rivals in the insurance technology space in going public. Though there are few confirmed details at the moment, Bright Health is reportedly looking to raise $1 billion through the offering.
Hospitals lose appeal to block CMS’ price transparency rule
A federal appeals court has ruled against hospital groups in their legal challenge to the CMS regulation that would require hospitals to make pricing information publicly available. The rule is set to take effect Jan. 1.
Acquisitions, new technology on payers’ radar for investments in 2021
In the new year, payers with an abundance of capital resulting from deferred care amid the pandemic will look to make investments in technology and ramp up acquisition activity in the primary care arena, a PwC expert predicts.