FinanceUnnecessary Healthcare Services Cost Colorado Patients and Insurers $134M in 2021
New analysis of low value care in the state looks at utilization and how it affected spending.
PayerMedicaid Managed Care Has High Rates of Prior Authorization Denials
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically...
FinanceIndustry Groups in California Vie for New Medicaid Money
Top state health officials say they plan to plow most of the money into higher payments for doctors, hospitals, and...
PayerElevance Health Nets $1.9B in Profits in Promising Q2
The payer saw "encouraging" signs that Medicaid members losing coverage are transitioning into Affordable Care Act (ACA) exchange plans.
PayerLawmakers Want Prior Authorization in Medicare Advantage Streamlined Even More
The group are urging CMS to enhance its proposed rule and build on the regulations for the administrative process.
PayerElevance Improves Maternal Health Outcomes at a Time of Crisis and Inequity
As maternal death rates rise for women of color, the Elevance Health Public Policy Institute reports improved outcomes for the...
FinanceHospital Expenses Continue to Rise as Operating Margins Hold Steady
A new report shows hospital operating margins have stabilized even as expenses show no signs of slowing down.
PayerBiden Admin Implores States to Slow Medicaid Cuts After More Than 1M Enrollees Dropped
Too many Americans are losing Medicaid coverage because of red tape, and states should do more to make sure eligible...
FinanceThe Debt Ceiling Deal Takes a Bite Out of Health Programs. It Could Have Been Much Worse.
Policy analysts, Democrats, and Republicans dissatisfied with the deal agree: Federal health programs have dodged a budgetary bullet in the...
FinanceHospital Finances Broke Even in April Amid Medicaid Disenrollment, End of PHE
Kaufman Hall finds inflation and high expenses continue to hinder hospitals' bottom line.
PayerFinancial Burden of Dual-Eligible Beneficiaries Split Evenly on Medicare, Medicaid
Research into utilization and spending for need-based subgroups suggests integration of the two programs could better serve enrollees.
Revenue CycleNW Arkansas Hospitals Will Pay $1.1M to Settle Medicaid False Claims Allegations
The health system denies intentionally filing false billings, and has worked with regualtors to resolve the case.