Revenue Cycle

Hospitals and Health Systems Projected to Lose About $54B in Net Income in 2021
Sicker patients and higher expenses are contributing to 'profound headwinds' AHA CEO says.
California's Reboot of Troubled Medi-Cal Puts Pressure on Health Plans
Poor care coordination is one of the many shortcomings of Medi-Cal, which covers over a third of the state's population...

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Anthem, UnitedHealthcare MA Plans Sanctioned for Missing MLR Threshold
When a Medicare Advantage plan fails for three straight years to meet the 85% threshold, CMS must suspend them from...
Intermountain, SCL Health Announce Merger Plans
The two health systems say they hope to have a definitive agreement finalized by year's end, and to close the...
Price transparency
Hospital Price Transparency Needs Harsher Penalties, Uniform Data Reporting
According to an expert panel, CMS should increase the maximum penalty for noncompliance with the pricing rule from $300 per...
Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage
Twenty-eight million people, or 8.6% of Americans, were uninsured for all of 2020. In 2019, 8% of people were uninsured...
Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?
Georgia is among more than 40 states that have turned to managed-care companies to control Medicaid costs.
Most of $9.2B in questionable Medicare payments went to 20 insurers, investigators say
Insurers gained higher payments by recording more medical conditions for patients, using controversial methods, according to investigators
Their baby died in the hospital. then came the $257K bill
A New York family had good health insurance. But the bills for their daughter's care started showing up and kept...
Feds penalize UnitedHealthcare plans for underspending premiums on medical care for seniors
The sanctions block the Minnetonka-based insurer from selling certain Medicare Advantage plans in six states, which represent a small percentage...
CT approves rate hikes for 2022 – though not as large as carriers sought
Connecticut consumers will see higher rates in many health insurance plans next year, though not as much of an increase...
Delaware issues $12.3M in health insurance rebates for individuals and small businesses
Insurance Commissioner Trinidad Navarro announced Wednesday that Highmark Blue Cross Blue Shield Delaware will issue rebates totaling over $12.3 million...
Companies starting to increase health insurance costs for unvaccinated workers
(WXYZ) ? If you're not vaccinated, you could face higher insurance premiums. Companies are starting to increase health insurance for...
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