Why Hospitals Are Losing the Financial Tug-of-War With Payers
Hospitals’ flat revenues are clashing with rising costs and excessive reimbursement denials from payers, said…
Why Hospitals Are Losing the Financial Tug-of-War With Payers
Hospitals’ flat revenues are clashing with rising costs and excessive reimbursement denials from payers, said Rod Hanners, CEO of Keck Medicine of USC. He warned that policy efforts focused solely on limiting provider payments ignore the larger issue of unchecked profits among payers, drugmakers and other healthcare industry players. The post Why Hospitals Are Losing…
New Bipartisan Bill from Rep. Carter Aims to Crack Down on PBMs
A bill introduced by Rep. Earl L. “Buddy” Carter would ban PBMs’ use of spread pricing in Medicaid, among other reforms. The post New Bipartisan Bill from Rep. Carter Aims to Crack Down on PBMs appeared first on MedCity News.
I’m on the Surgeon’s Record
If you want to hear a little about Commons Clinic from Benjamin Schwartz, MD but rather more from me about who knows what, it’s on The Surgeon’s Record podcast — Matthew Holt
Demand for 988 Continues to Grow at Third Anniversary
This policy watch examines 988 on its third anniversary, drawing from the latest Lifeline data available through May 2025 and suicide death data from CDC WONDER for the period 2013 to 2023. 988 received 16.5 million contacts since its launch in July 2022, including 11.2 million calls, 2.9 million texts, and 2.4 million chats.
Bayer’s Blockbuster Hopeful Kerendia Expands its FDA Approval to Type of Heart Failure
The FDA approved Bayer’s Kerendia for reducing the risk of heart failure in patients with mildly reduced ejection fraction, a measure of how much blood the organ can pump. The daily pill was first approved in 2021 for patients with chronic kidney disease associated with type 2 diabetes. The post Bayer’s Blockbuster Hopeful Kerendia Expands…
Most Medicare Advantage Markets are Dominated by One or Two Insurers
Higher market concentration in Medicare Advantage insurance markets may lower the incentive for insurers to compete for potential enrollees by making plans more appealing through more comprehensive benefits or lower costs.
Behavioral Health Has A Data Problem. Health Plans Are Sitting On The Solution
It’s not that the data isn’t there. We have years of claims, pharmacy, and clinical data that can tell who’s at risk for serious behavioral health disorders, who’s currently being treated for them, and what actually works. The problem is how health plans are looking at all that data. The post Behavioral Health Has A…
Is Your Practice’s Payment System Holding You Back? Ask These 3 Key Questions
Efficient payment processing plays a central role in the success of healthcare practices, shaping everything from staff productivity and cash flow to patient satisfaction. The post Is Your Practice’s Payment System Holding You Back? Ask These 3 Key Questions appeared first on MedCity News.
From Plateau to Progress: Unleashing Growth in GI Practices Through Innovation and Alignment
In today’s environment, standing still is the riskiest strategy of all. But to move from plateau to progress, GI practices must redefine what growth looks like. The post From Plateau to Progress: Unleashing Growth in GI Practices Through Innovation and Alignment appeared first on MedCity News.
In Rush To Satisfy Trump, GOP Delivers Blow to Health Industry
Doctors, hospitals, and health insurers for weeks issued dire warnings to Republican lawmakers that millions of people would lose health coverage and hospitals would close if they cut Medicaid funding to help pay for President Donald Trump’s big tax and spending bill. But Republicans ignored those pleas, made even deeper cuts, and sent the legislation…
