Nearly a year after the federal government launched the independent dispute resolution (IDR) process under the No Surprises Act, over 330,000 balance billing disputes have been filed, nearly 14 times...
Lawmakers have their eyes on pharmacy benefit manager (PBM) reform, but one bill is looking to take it a step further by requiring commercial payers to share pharmacy claims data with providers to...
The COVID-19 public health emergency (PHE) has officially ended, and with it, so have policies that helped healthcare providers navigate challenging circumstances, including provider relief funds and...
Revenue growth exceeded expense increases in March 2023, resulting in positive hospital operating margins for the first time in 15 months, according to a report from Syntellis Performance...
As Medicare Advantage enrollment grows, medical practices are experiencing more prior authorization burdens, including higher administration costs and disrupted workflows, a report from the Medical...
In the age of high deductibles, providers are increasingly turning to financial institutions and fintech companies to offer medical credit cards and installment loans to their patients. However, a new...
Patients who see cardiologists employed by hospitals are significantly more likely to receive high-intensity, hospital-based coronary interventions compared to patients who see independent doctors,...
Participation in the 340B drug pricing program was associated with reduced biosimilar use and more biologic administrations, a study published in Health Affairs found.
The 340B program allows eligible...
Hospital operating margins are stabilizing after a turbulent couple of years. However, margins remain below pre-pandemic levels, which makes hospitals and health systems vulnerable to a possible...
After CMS began incorporating regional spending into accountable care organization (ACO) benchmarks in the Medicare Shared Savings Program (MSSP), more higher-spending ACOs exited the program, a study...
Health inequity is costing the Medicare program more than $60 million on preventable heart failure hospital admissions, suggests a new study out of Tulane University.
The study published in the most...
Private equity acquisition of oncology practices has grown in the past two decades, with over 700 clinics becoming affiliated with a private equity firm between 2003 and 2022, a study published in JAMA...
HHS and DHS are starting the process of ending the COVID-19 vaccine requirement for CMS-certified healthcare facilities, as well as Head Start educators and certain noncitizens at the borders.
The...
The American Medical Association (AMA) and more than 100 other provider trade associations have taken issue with a new policy from The Cigna Group regarding claims with modifier 25.
Cigna recently...
Intermountain Health recently announced it signed a collaborative agreement for Tennessee-based Surgery Partners to take over management of its ambulatory surgery centers (ASCs) in certain markets...
Skilled nursing facility (SNF) episodes for Medicare beneficiaries without preceding acute care increased during the COVID-19 public health emergency (PHE), a study published in JAMA Internal Medicine...
California-based integrated health system Kaiser Permanente recently announced that it has agreed to acquire Geisinger Health, a 10-hospital system on the East Coast, in an effort to develop a new...
CMS is cracking down on hospital price transparency compliance — or lack thereof.
The federal agency announced yesterday updated enforcement procedures, including earlier and automatic civil...
Value-based care participation is lacking among primary care physicians; most practices reported receiving fee-for-service payments in 2022, according to data from the Commonwealth Fund.
Value-based...
Financial reserves have helped nonprofit hospitals and health systems survive amid ongoing operational and economic challenges, according to a report prepared for the American Hospital Association...