The GOP’s Budget Plan Is a Crisis in the Making for Hospitals

If enacted, the GOP’s spending bill would kick more than 10 million Americans off Medicaid. Experts are worried about the major spike in uncompensated care that hospitals would have to provide — and they’re warning that this change will result in major revenue losses for hospitals, facility closures, higher premiums for commercially insured patients, and…

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Rate Reality Check: How Capital Women’s Care Stacks Up Against the Competition (Part 2)

By JASON HINES This is Part 2 of Jason and Gigasheets’ investigation into the Capital Women’s Care vs UnitedHealthcare contract dispute in which (partially at my request) he expanded the investigation to look at other providers in the same market. Revealing stuff!–Matthew Holt While Capital Women’s Care (CWC) battles UnitedHealthcare over contract terms, a deeper look at…

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The Medicare Advantage Influence Machine

Federal officials resolved more than a decade ago to crack down on whopping government overpayments to private Medicare Advantage health insurance plans, which were siphoning off billions of tax dollars every year. But Centers for Medicare & Medicaid Services officials have yet to demand any refunds — and over the years the private insurance plans…

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From FOMO to FOMU: A Framework for Getting AI Right

Healthcare is a highly regulated industry, and any use of AI within it is dealing with the most sensitive data. In order to ensure you’re not putting you, your company or patients at risk, consider an evaluation framework for any AI tool that considers these three things. The post From FOMO to FOMU: A Framework…

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