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 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
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…
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.
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
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…
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…
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’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….
January has seen a slew of executive hires, promotions and layoffs across the healthcare industry. For example, health tech companies like Medtronic and athenahealth hired new C-suite leaders, and providers like Cleveland Clinic and Jefferson Health announced rounds of job cuts. The post Healthcare Moves: A Monthly Summary of Hires, Exits and Layoffs appeared first…