Ardent Executives Look Beyond Urgent Care in Outpatient Plans
Surgery centers are the next focus, President and CEO Martin Bonick told a recent industry conference. But that push is more likely to be about building than buying.
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5 Critical Lessons from Year One of Hybrid Measure Submissions
The transition to hybrid measures in 2024 has been more than just a regulatory requirement — it’s been a catalyst for meaningful change in how we approach quality reporting. Here are five critical insights that can help healthcare organizations comply with requirements and excel in their quality reporting journey. The post 5 Critical Lessons from…
HealthCare.gov Insurers Denied Nearly 1 in 5 In-Network Claims in 2023, but Information About Reasons is Limited in Public Data
HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services and an even larger share (37%) share of claims for out-of-network services in 2023, a new KFF analysis finds. The analysis examines the main source of publicly available data on claims denials and appeals for individual-market plans available through the…More
Claims Denials and Appeals in ACA Marketplace Plans in 2023
This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for…
Bridging the Gap Between Herbal Wisdom and Scientific Research
What if these two worlds weren’t at odds? What if they were two parts of the same story, waiting to be brought together for the benefit of all? The post Bridging the Gap Between Herbal Wisdom and Scientific Research appeared first on MedCity News.
Feb. 10 Virtual Event: The Health Wonk Shop: What’s Next for the Affordable Care Act?
Health coverage enrollment through the Affordable Care Act (ACA) marketplaces now exceeds 24 million people, a dramatic increase in recent years fueled largely by enhanced premium aid, which started in 2021 as part of the American Rescue Plan Act and extended through 2025 under the Inflation Reduction Act. But, with the subsidies set to expire…More
An Arm and a Leg: The ‘Shkreli Awards’ — For Dysfunction and Profiteering in Health Care
Every year, a health care think tank called the Lown Institute ranks the 10 worst examples of “profiteering and dysfunction” in health care and “honors” the winners. The “Shkreli Awards” are a kind of Oscars for the most outrageous examples of greed, fraud, and general brokenness in American health care. The awards are named after…
Montana Eyes $30M Revamp of Mental Health, Developmental Disability Facilities
HELENA, Mont. — As part of a proposed revamping of the state’s behavioral health system, Republican Gov. Greg Gianforte’s administration is looking into moving a facility for people with developmental disabilities, beefing up renovations at the Montana State Hospital, and creating a Helena unit of that psychiatric hospital. The changes, backers say, would fill gaps…
Are ICHRAs Actually Good for Employers and Employees?
ICHRAs are gaining a lot of interest in healthcare. Some say they are beneficial because they give employees more choice in their health insurance, while others are more skeptical. The post Are ICHRAs Actually Good for Employers and Employees? appeared first on MedCity News.
Novo Nordisk Obesity Drug Shows 22% Weight Loss, But Lack of Safety Detail Is a Sticking Point
Novo Nordisk’s amycretin is a single molecule designed to bind to two targets to spark weight loss — a different approach than some of the pharma giant’s other efforts to develop next-generation obesity drugs. Analysts say the lack of details safety and tolerability details make it difficult to fully assess the preliminary Phase 1b/2a results….