Junk health plans are in the crosshairs of the Department of Health and Human Services, which pledged this week to protect consumers from such plans, as well as surprise medical bills and excess costs that lead to medical debt.

An employee benefits group at Kraft Heinz Co. has filed a lawsuit against insurer Aetna, accusing the company of breaching its fiduciary duties by leveraging its status as a third-party claims administrator to benefit itself financially.

Biometric wearables predicted 73% of COVID-19 cases more than two days before service members felt sick, says Jeffrey Schneider at DoD and Navin Natoewal at Philips.

NASHVILLE – Transactional revenue cycle no longer works with patients, especially millennials, said finance experts speaking during the HFMA conference in Nashville. It used to be, do the service and then bill, said Bob Stearns, director of Patient Accounting, Covenant Health.

The Medicare Advantage quality bonus program, established by the Affordable Care Act as part of a package of MA reforms, was expected to reduce payments to MA organizations. But according to a new Urban Institute report, the expected cost savings from the reforms have not materialized.

Following backlash, U.S. News and World Report has made a number of changes to its methodology for its upcoming Best Hospitals rankings, which are due for release on August 1. Officials from U.S. News, including Managing Editor and Chief of Health Analysis Ben Harder and senior health data scientist Dr. Min Hee Seo, released 18 […]

Healthcare costs are expected to increase as much as 7% in 2024 due to continued labor shortages, drug price increases and new contracts between payers and providers – representing a larger jump in costs than in either of the previous two years.

South Dakota has decided to expand Medicaid under the Affordable Care Act, and according to the Department of Health and Human Services, this will result in new eligibility for health coverage for about 52,000 residents of the state, including many members of South Dakota tribes.

NASHVILLE – Automation, particularly through AI, holds the promise of greater efficiency and fewer denials in the revenue cycle. There’s $9.8 billion in potential savings through automation in the revenue cycle, according to statistics provided by TruBridge, a consultant and IT services provider. Nine percent of all claims are rejected in error or from prior […]

Hospitals can adapt by rolling out FHIR APIs for patient access, says ZeOmega associate VP of interoperability strategy Michael Gould and VP of advanced analytics Pravin Pan.