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Free Newsletters
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Search the News Archive
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284 Matching News Items |
| 1. |
HealthLeaders
Jan. 23, 2004
Excerpt: Health plans have been slow to integrate prevention programs into their business plans. But HealthLeaders Research Senior Correspondent John Harkey says some health plans are experimenting with ways to change that.
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| 2. |
HealthLeaders
Sept. 4, 2003
Excerpt: Taking inducements to prescribe certain drugs is more than ethically questionable. It's against the law, says HealthLeaders member Kenneth Nolan, and healthcare leaders had better know what the penalties are and how to avoid any trouble in the first place.
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| 3. |
HealthLeaders
June 30, 2003
Excerpt: With escalating health insurance premiums, a growing number of Americans without healthcare coverage, widespread evidence of avoidable medical errors and skyrocketing medical liability costs for certain physician specialties, the time is again ripe for calls to reform and redesign our nation's healthcare financing and delivery systems. In the second installment of a four-part series, HealthLeaders member Brad Stephan shares his views on what it will take to make things right.
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| 4. |
HealthLeaders
Dec. 19, 2025
"The current focus on ghost networks provides a timely catalyst for health plans to strengthen their provider data management processes. A good first step is defining what accuracy and completeness mean for your organization. Set measurable standards; for example, determine how often data must be updated and what percentage of records must be verified at each cycle."
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| 5. |
HealthLeaders
Nov. 10, 2025
"Almost 4 in 10 disputes submitted to the IDR process are deemed ineligible by insurers, often due to errors such as resubmitted cases, claims covered by state laws, or services involving in-network providers. Both payers and providers face mounting costs and delays as IDR entities struggle to filter invalid cases, complicating cash flow for health systems. CFOs should tighten eligibility checks, track dispute-to-payment metrics, and align closely with revenue cycle teams to minimize rejected filings and improve reimbursement efficiency."
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| 6. |
HealthLeaders
Oct. 14, 2025
"The NSA's arbitration system has generated $5 billion in total costs since 2022, including $2.24 billion in direct provider payments and $1.9 billion in internal costs. A flood of disputes has overwhelmed the system, creating a backlog of nearly 500,000 cases and pushing the median time for a decision to 81 days. Providers won 85% of disputes in 2024, but the benefits are highly concentrated, with just five organizations responsible for 59% of all claims."
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| 7. |
HealthLeaders
Sept. 4, 2025
"The Patients Deserve Price Tags Act [S 2355] ... aims to increase transparency around healthcare prices by establishing new requirements for virtually all healthcare stakeholders and creating stronger mandates for federal agencies to enforce compliance."
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| 8. |
HealthLeaders
July 24, 2025
"Hundreds of thousands of Massachusetts residents will see their premiums increase by 7% to 12% next year. The Division of Insurance approved 2026 rates for six insurers in the merged market, which provides a subset of Bay Staters with health insurance through individual and small business plans."
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| 9. |
HealthLeaders
Apr. 4, 2025
"[1] To understand how well their mental health benefit is working, employers must ask fundamental questions ... [2] Engage employees and get their feedback ... [3] Meet growing need with diverse, expanded resources ... [4] Strengthen health plan oversight to prevent access obstacles ... [5] Treat mental health supports as a moral and business imperative."
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| 10. |
HealthLeaders
Feb. 27, 2025
"UnitedHealthcare is in the hot seat once again, this time for fraudulent Medicare Advantage billing practices, placing the health insurance giant under a civil fraud investigation by the Department of Justice. Specifically, the Department of Justice (DOJ) is evaluating the company's protocols for recording diagnoses that can result in extra payments for the company's Medicare Advantage plans[.]"
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