Tag: Administrative burden
What to expect in 2025: Managed care trends and predictions
New president. New Congress. Decades old healthcare cost finger pointing. Payors and providers say change is needed. Yet there’s no consensus on how to achieve it. In our new report, we share...
Prior authorizations should be renamed ‘the Care Avoidance Process’
The widespread use of prior authorizations by insurers delays care, undermines physician-patient relationships, and improperly denies treatment, highlighting the urgent need for collective provider action and stronger protections against these...
So much Medicare Advantage noise, so little time
Medicare Advantage plans have grown significantly, benefiting insurers through higher taxpayer costs driven by coding intensity, while raising concerns about their effectiveness and necessitating strategic evaluation by providers and government...
Three things you need to know about Medicare Advantage today
Medicare Advantage's rapid growth is straining hospitals and health systems due to low reimbursement rates, rising denials, and payment disputes, requiring providers to adopt data-driven strategies and proactive contract negotiations...
2023 revenue challenges: Turning the tide in 2024
In 2023, hospitals and health systems faced financial pressures from Medicaid redeterminations, Medicare Advantage's rapid growth, and shifting expectations of commercially insured patients, requiring proactive strategies in reimbursement, contract negotiations,...