Fierce Healthcare

FEBRUARY 1, 2024

A recommendation on the 2024 Measures Under Consideration list, brought forward by the Federation of American Hospitals (FAH), would add a quality measure in the Medicare Advantage (MA) star rating | The Federation of American Hospitals is pushing CMS for the inclusion of a star ratings quality measure that shows how often insurers overturn or uphold (..)

Insurance 128

Insurance Hospitals 128

STAT

MARCH 7, 2025

  The sprawling conglomerate — which owns a major health insurance company, physician practices, a pharmacy benefit manager, and numerous other firms — acquired or created more than 250 subsidiaries in 2024. UnitedHealth Group, the largest health care company in the U.S., has clear ambitions of getting bigger. 

Health Insurance Companies 144

Health Insurance Companies Insurance Documentation Hospitals 144

Fierce Healthcare

SEPTEMBER 19, 2024

Major Indiana managed care organizations and health systems are blamed for defrauding the state Medicaid system by tens, if not hundreds, of millions of dollars, says a newly unsealed whistleblower | A newly unsealed lawsuit alleges major health insurers and health systems defrauded Indiana Medicaid by hundreds of millions of dollars, with the government (..)

Insurance 137

Insurance Hospitals 137

PhRMA

NOVEMBER 21, 2022

Research has shown that 340B hospitals are more likely to prescribe more expensive medicines and significantly mark up the price of medicines. For example, 340B hospitals received nearly five times what they paid, on average, to acquire oncology medicines through 340B.

Hospitals 284

Hospitals Insurance 284

STAT

OCTOBER 17, 2024

The nation’s three largest Medicare Advantage insurers increasingly refused to pay for rehabilitative care for seniors in the years after adopting sophisticated technologies to aid in their coverage decisions, a Senate investigation found. The report, conducted by the U.S.

Insurance 145

Insurance Nursing Homes Hospitals 145

STAT

AUGUST 2, 2024

Contract disputes between hospitals and health plans have become routine, but they tend to be local , affecting a handful of hospitals and the people in the surrounding communities. It involves the country’s biggest private health insurer, UnitedHealthcare, and its biggest hospital chain, HCA Healthcare.

Hospitals 145

Hospitals Insurance 145

STAT

NOVEMBER 20, 2023

Hospitals’ list prices for surgeries, therapies, and other procedures always come with massive discounts. Financial documents at a prominent hospital system in Los Angeles show just how large those discounts are — and how raw of a deal uninsured patients could be getting. Cedars-Sinai reported more than $10.2

Hospitals 135

Hospitals Documentation Insurance 135

STAT

JANUARY 7, 2024

Nonprofit hospitals often get overshadowed at the J.P. But hospitals are still the largest part of America’s health care economy, commanding nearly a third of the country’s $4.7 But hospitals are still the largest part of America’s health care economy, commanding nearly a third of the country’s $4.7

Hospitals 113

Hospitals Insurance 113

STAT

OCTOBER 26, 2023

WASHINGTON — Democrats unilaterally drove major reforms to the health insurance and the pharmaceutical industries without a single Republican vote in recent years. But hospitals may be a health care giant they’re unable to confront alone. They have campaigned on passing health insurance reform, and then protecting it.

Hospitals 142

Hospitals Insurance 142

STAT

SEPTEMBER 10, 2024

Elevance Health, the parent of more than a dozen state Blue Cross Blue Shield plans, is purchasing Indiana University Health’s insurance business in a deal that would increase its dominance in several key cities in the state. Several other hospital-owned insurance companies have flamed out over the past several years.

Insurance 106

Insurance Health Insurance Companies Hospitals 106

STAT

JULY 25, 2024

Insurers like UnitedHealth are profiting off of the Medicare Advantage system, and it’s causing problems for both doctors and patients. Traditional Medicare is run by the federal government, while Medicare Advantage health insurance plans are operated by private companies like UnitedHealth. Read the rest…

Insurance 143

Insurance Hospitals 143

STAT

SEPTEMBER 6, 2023

More older adults have been hospitalized for Covid-19 over the past several weeks, according to internal data reviewed by health insurance giant Humana. But it didn’t expect the uptick to come during the waning summer months.

Hospitals 137

Hospitals Insurance 137

Fierce Healthcare

FEBRUARY 28, 2023

Insurance Companies’ QZ Anesthesia Reimbursement Policies Shifts Costs to Hospitals jpiatt Tue, 02/28/2023 - 12:15

Insurance 98

Insurance Hospitals 98

STAT

APRIL 26, 2024

MultiPlan is facing a new class action lawsuit that alleges the company and large health insurers “conspired to fix, suppress, and stabilize” payments made for out-of-network medical claims. Continue to STAT+ to read the full story…

Hospitals 123

Hospitals Insurance 123

STAT

JANUARY 10, 2024

A lawsuit between a large hospital system and a dominant vendor that works for health insurance companies is getting a lot more heated — with one party calling the other an “economic parasite.” Morgan Healthcare Conference. AdventHealth did not attend this year’s conference, but did so last year.

Hospitals 130

Hospitals Health Insurance Companies Insurance 130

STAT

JULY 10, 2024

The federal government will not modify regulations that dictate how hospitals publish their prices for consumers, ignoring pleas from patient advocates who have said hospitals still are not fully complying with the 3-year-old law. The Biden administration on Wednesday proposed an annual rule that sets payment rates for hospitals.

Hospitals 128

Hospitals Health Insurance Companies Documentation Insurance 128

STAT

AUGUST 4, 2023

The federal government will pay hospitals that treat poor and uninsured patients almost $1 billion less next year, a cut that’s more than eight times larger than the one proposed in April. The Centers for Medicare and Medicaid Services originally said it would cut payments meant to help safety net hospitals by $115 million in 2024.

Insurance 98

Insurance Hospitals 98

STAT

JANUARY 17, 2024

The Biden administration moved Wednesday to force insurance companies to give specific reasons for denying coverage, and to speed up the pre-approval process in general. The new rule applies to health insurance companies that offer Medicare, Medicaid, Children’s Health Insurance Program, and Obamacare plans.

Insurance 135

Insurance Health Insurance Companies Hospitals 135

Fierce Healthcare

MAY 6, 2024

The Hospital Insurance Trust Fund will be fully solvent for longer than previously projected, according to an annual Medicare Trustee report. | The Medicare Hospital Insurance Trust Fund won't run out of money as quickly as expected. Here's how federal officials are reacting.

Hospitals 126

Hospitals Insurance 126

STAT

FEBRUARY 13, 2025

People often blame our health care system — hospitals, doctors and other health providers, insurers — as the reason for the disappointing performance on life expectancy at birth. Yet the United States ranks second in the world when it comes to self-reported health status.

Insurance 121

Insurance Hospitals 121

STAT

FEBRUARY 5, 2024

Starting this year, private Medicare plans have to cover their members’ hospitalizations at the higher inpatient rate if their doctors predict they’ll have to stay beyond two midnights. For patients with MA plans, it could mean better access and smaller out-of-pocket costs after a hospitalization.

Insurance 126

Insurance Hospitals 126

STAT

JUNE 3, 2024

More than a year ago, Kaiser Permanente made waves when it said it was creating a new, sprawling entity of nonprofit hospitals and doctors with Geisinger as its first takeover — the latest example of health care companies bulking up in an already highly consolidated industry. Nothing has happened since then, at least publicly.

Hospitals 123

Hospitals Health Insurance Companies Insurance 123

STAT

JANUARY 8, 2024

SAN FRANCISCO — If you learned anything about nonprofit hospitals on the first day of the J.P. Instead, they’re fully throwing their weight into other ways of making money — things like developing drugs or selling insurance.

Hospitals 139

Hospitals Patient Care Insurance 139

STAT

APRIL 4, 2024

The prices charged by hospitals are exorbitant and rising. Private health insurance premiums paid by working age adults are rising rapidly. Here’s just the tip of the iceberg: $722.50 for a nurse to push a drug into an IV. 21,500 for ten stitches.

Hospitals 140

Hospitals Insurance 140

STAT

APRIL 17, 2024

Federal rules forcing hospitals and insurers to post rates for medical procedures have taken effect, but the data’s so messy that a crop of new startups is rushing in to make a business out of parsing it for whoever is willing to pay.

Hospitals 126

Hospitals Insurance 126

Fierce Healthcare

DECEMBER 14, 2023

A new price comparison study finds over 50% higher facility fees for commercially insured colonoscopies performed in hospitals rather than ambulatory surgery centers (ASCs), suggesting that “money | The analysis of commercial payers' price transparency data shows that “money has apparently been left on the table” for employers and consumers, the (..)

Hospitals 138

Hospitals Insurance 138

Fierce Healthcare

JUNE 24, 2024

Higher care costs directly following a hospital merger have a downstream effect of local employers laying off a portion of their workers, according to a new National Bureau of Economic Researc | A new analysis ties merger-driven hospital price increases to higher employer insurance premiums and subsequent headcount reductions.

Hospitals 116

Hospitals Insurance 116

Fierce Healthcare

JANUARY 23, 2024

Over half of the country’s rural hospitals aren’t offering labor and delivery services, and many of those that are could soon be forced to end maternity care due to financial losses, according to t | Many rural facilities that do still deliver are facing financial struggles that could force a shutdown, the Center for Healthcare Quality and Payment (..)

Hospitals 130

Hospitals Insurance 130

STAT

NOVEMBER 3, 2023

The federal government is moving forward with a spate of proposals that will force hospitals to be better about publishing the prices they charge health insurers and patients. Federal law has required hospitals to post their prices since 2021. But the pricing information is still tough to find and confusing to interpret.

Hospitals 123

Hospitals Insurance 123

STAT

NOVEMBER 3, 2023

1  start to the annual open enrollment period, the advertising engines for state health insurance marketplaces, and the federal exchange,  healthcare.gov , have been revving up. ’Tis the season — open enrollment season, that is. Since before the Nov.

Insurance 139

Insurance Documentation Hospitals 139

STAT

MAY 15, 2023

UnitedHealthcare and Phoenix Children’s Hospital are embroiled in a bitter contract dispute that would lock out families and children from care at the hospital by June if the two sides don’t come to a new agreement. Continue to STAT+ to read the full story…

Hospitals 98

Hospitals Insurance 98

STAT

JUNE 21, 2024

But the relatively small system has an outsized reputation for keeping locals healthy and out of hospitals, according to the CEO of the health care network that struck a deal to acquire it. based nonprofit collective of doctors, hospitals, and health insurers, last year. Kaiser Permanente formed the Washington, D.C.-based

Hospitals 121

Hospitals Insurance 121

STAT

SEPTEMBER 9, 2024

NEW YORK — One Brooklyn Health, a safety net hospital system that serves some of this city’s poorest and sickest patients, would seem to be exactly the place to benefit most from the effort to remove race from calculations that assess kidney disease.

Hospitals 135

Hospitals Insurance 135

STAT

FEBRUARY 15, 2024

drug discount program overcharged the federal government and numerous hospitals by hundreds of millions of dollars, according to claims made in a recently unsealed lawsuit. The federal government program requires drugmakers to offer discounts on all outpatient drugs used by hospitals and clinics that primarily serve lower-income patients.

Hospitals 132

Hospitals Pharmaceutical Companies Pharmaceutical Companies Insurance 132

STAT

DECEMBER 26, 2023

Hospitals acquired by private equity saw a 25% uptick in adverse events compared with controls, according to a new study released today in the Journal of the American Medical Association. There’s ample evidence that private equity buyouts in health care drive up costs. A new study shows quality declines, too.

Hospitals 145

Hospitals Nursing Homes Insurance 145

STAT

OCTOBER 2, 2023

Health care providers and health insurance companies are closing the books on their third quarters, and one major question continues to hang over them: How much care is everyone actually getting, now that Covid-19 isn’t scaring so many away from doctors and hospitals? Continue to STAT+ to read the full story…

Hospitals 113

Hospitals Health Insurance Companies Insurance 113

STAT

JANUARY 25, 2024

The federal government is suing to block a proposed hospital deal in North Carolina, alleging it would hand control of over 65% of the inpatient market in the region to a single provider. billion in 2022 revenue, plans to buy two hospitals in the same county from the for-profit chain Community Health Systems for $320 million.

Hospitals 119

Hospitals Insurance 119