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The Mock Claim Proposal: A New Approach to Health Care Cost Transparency
The AHA and other stakeholders have proposed a practical and scalable solution: the mock claim proposal.
Walmart Enters New Phase of Its Health Care Relationship with Consumers
Walmart’s strategy is simple: Find ways to help customers save money and live better. With its ever-expanding reach into health care, however, Walmart has entered a new phase by becoming a licensed health insurance broker in an effort to forge stronger bonds with millions of consumers.
Hospital Trendwatch Chart 1.14: Number and Percent Uninsured, 1990-2019, 2021, and 2022
See hospital trends in AHA Trendwatch Chartbook Chart 1.14: Number and Percent Uninsured, 1990-2019, 2021, and 2022.
Who’s Really Driving Physician Acquisitions?
A new AHA analysis of data from LevinPro HC covering nearly 800 physician practice acquisitions between 2019 and 2024, reveals that commercial insurers and corporate entities like Amazon continue to lead acquisitions, with a particular emphasis on acquiring higher-margin, scalable specialties in densely populated markets rather than lower-margin specialties.
Should You Automate to Resolve Health Claim Denials?
Absent commercial health insurance companies fulfilling a recent promise to reform their prior authorization (PA) and claims-paying behaviors, what can hospitals and health systems do to combat increasing claim denials and their growing threat to clinical and financial sustainability?
The Case for Automating to Resolve Health Insurance Claims Denials
Automating health care insurance claims management with AI-powered tech can speed denials resolution - TrailBlazers
New Solution Helps to Address Unfair Commercial Health Care Plans
To help members reduce the significant operational challenges caused by some of these commercial payer issues, the AHA has also launched a new solution, the AHA Vitality Index.
Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Impacting Patient Care
Between 2022 and 2023, care denials increased an average of 20.2% and 55.7% for commercial and Medicare Advantage (MA) claims, respectively.
Payer Denial Tactics — How to Confront a $20 Billion Problem
The high cost to health care providers to obtain reimbursement from insurers shows no signs of abating. A recent report from the group purchasing and consulting organization Premier highlights the long-standing problem.
CY2024 Medicare Advantage Final Rule Implementation Handbook
On April 5, the Centers for Medicare & Medicaid Services (CMS) finalized its Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program for contract year (CY) 2024. The final rule increases oversight of Medicare Advantage (MA) plans and seeks to better align MA coverage with Traditional Medicare.