Compliance
This section focuses on health care compliance and regulations – both national and state – including the ACA. It includes changes in health care law, regulation, and court decisions and their impact on health insurance professionals, employers, and individuals.
Nearly three-quarters of metropolitan statistical areas are concentrated health insurance markets, according to a new study from the American Medical Association (AMA). The analysis (PDF) found that 73% of MSAs are highly concentrated, based on Department of Justice and Federal Trade Commission horizontal merger guidelines. In 91% of markets, a single insurer had a market share of ...
Surveys have shown that as many as half of unvaccinated workers say they will leave their jobs if they’re forced to get the COVID-19 shot, but in reality few of them actually quit. That’s according to an article in The Conversation, a nonprofit news organization that covers academic research. Researchers looked at companies that have vaccine ...
Top House Democrats are voicing a new willingness to pare down their ambitious health care proposals within the sweeping $3.5 trillion social spending bill as they scramble to build consensus ahead of a potential vote this week.
The Affordable Care Act (ACA) requires health insurance issuers to provide information on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR).
Health insurance is a constantly evolving and complicated industry that continues to change with the needs of the people, and it's only getting more complicated by the day. With new regulations and guidelines, new technology for data management, and emerging preferences for user experiences, it's easy to feel lost as you navigate this evolving landscape with your business.
In the past 18 months, the healthcare industry has been defined by a time of sustained innovation and continuing technology investment. Health plans recognize the opportunity to collaborate with providers to deliver more patient-centric care and remove cost from the system. As government regulations and market forces converge around these initiatives, now is the time ...
The American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients, opposition that could prove pivotal as Democrats look to make cuts in their $3.5 trillion domestic policy agenda. Giving dental, vision and hearing benefits to the 60 million older and disabled Americans covered by Medicare will provide ...
Out-of-pocket spending for hearing and dental care far outpaced spending for vision care among Medicare beneficiaries, a new analysis found. The analysis, released Tuesday by the Kaiser Family Foundation, examines out-of-pocket spending in 2018 and 2019 on traditional Medicare and Medicare Advantage on the three benefits. It comes as Congress is contemplating adding the three benefits ...
Hospitals’ August financials bowed under the weight of the COVID-19 delta variant, albeit not nearly to the extent they did during the widespread disruption of 2020, per Kaufman Hall. According to the group’s latest monthly report on industrywide performance, upticks in new COVID-19 cases and hospital admissions maintained pressure on hospitals’ bottom lines. By most ...
As schools and businesses weigh their options for tracking COVID-19 cases, UnitedHealth Group’s researchers have developed an online calculator tool these organizations can use to game out potential testing programs. The free tool allows users to simulate the financial cost as well as the likely number of false positives for several different testing options and frequencies. For ...