Reimbursement

Half of adults who challenged coverage denials reported success in getting some or all denied services approved, survey shows.

For 2025, CMS is increasing the long-term care hospital standard payment rate by 3%.

CMS did not finalize the ability for follow-up visits to be conducted by telehealth.

The government subsidy to Part D plans is shifting from being reconciled on the backend to a larger risk-adjusted payment upfront.

Cody Coonradt, Billy’s CEO and founder, says patients are now able to negotiate prices for medical procedures and lower their bills by having location-based access to hospital pricing data.  

The plaintiffs claim that Change failed to implement cybersecurity safeguards such as multifactor authentication.

The hybrid payment structure may result in payment decreases that cannot be absorbed, the AHA said.

AI can mine data to identify patterns in a patient’s history, access medical records to automate claims and lead to a self-service model, say Oron Afek, CEO of Vim and Ashok Chennuru, global chief data and insights officer, Elevance Health.  

Marketing and branding have emerged as the foremost strategic growth priorities, with CFOs saying these areas are critical.

Groups are calling on Congress to prevent the proposed 2.93% proposed payment reduction for 2025.