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Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.
Care and Access
Payors create administrative burdens and restrictive policies that prevent patients from accessing care and block providers from delivering it.
Sugar and spice, not everything’s nice…
It’s the holiday season, a time for peace and goodwill, right? Well, not quite. Because it’s also the season for contract negotiations, err . . . disputes. And it looks like insurers… Read More
Is it just us, or are claim denials on the rise?
Over the past year, hospitals across the nation have experienced a rise in denied medical claims from insurance companies. According to a recent article in Modern Healthcare, approximately 67% of healthcare leaders… Read More
News flash: North Carolinians don’t trust their health insurance provider.
According to a recent poll conducted by Raleigh-based Meredith College, most North Carolinians don’t believe their health insurance provider has their best interest in mind. For some of you, this might seem… Read More
Insurers keep winning as the healthcare profit gap widens
That payor-provider gap? It’s becoming an abyss. At this point, it’s clear that the U.S. healthcare system is simply breaking down — with billions of dollars being funneled toward insurance company shareholders,… Read More
Put up your dukes. Insurers are coming out swinging.
Contract negotiations are nothing new – hospitals and insurance companies renegotiate their rates for services regularly. But the trend of the last few years is upped aggression from payors, where networks are… Read More
More people are covered by health insurance – but health insurance covers less
Here’s the good news: The number of Americans with health insurance is hitting historic highs. And the bad news: The health insurance itself is inadequate. According to recent findings from the Commonwealth… Read More
Can the feds finally make mental health parity a reality? Here’s hoping…
The future of mental health coverage parity remains uncertain, according to a recent article from Axios. But it’s not for lack of trying. For the upcoming legislative session in February, the Senate… Read More
California governor shoots down bill to protect patient access
It’s an unfortunate ending for California patients – a utilization management bill successfully passed the state Assembly and Senate, just to be vetoed by Governor Gavin Newsom. Sponsored by California Assembly member Dr.… Read More
Rural hospitals are necessary. So why do they keep closing?
Rural hospitals are literal lifelines for the communities they serve. And yet, they keep closing across the country. A new report from the American Hospital Association (AHA) is sounding the alarm, as… Read More
Need medical care? Better prove it.
We all (unfortunately) know that getting your care covered by insurance is anything but simple. And for families with children with autism spectrum disorder, insurers like Trustmark Health Benefits make the process… Read More
Hey North Carolina, where’s the outrage on insurance increases?
Only in the insurance industry can a business secure a $500 million-dollar profit and demand that consumers pay more. According to a September 1 article published in North Carolina News, Blue Cross… Read More
The real reason for North Carolina’s mental health crisis
When health insurers stand in the way of preventive mental healthcare, the results can be dire. Though they are supposed to cover mental healthcare on par with physical healthcare services, the reality… Read More
No kidding: Americans dissatisfied with health insurance plans
Well, well, well . . . if it isn’t the pot calling the kettle black. A new poll revealed that most American consumers are dissatisfied with their health insurance plans. You don’t… Read More
With big premium bumps, Northeastern consumers may be facing a frigid financial future
We’re not saying we told you so, but we are saying we saw this coming. Health insurance premiums are up nearly 14%, and consumers across the States are already facing inflated insurance… Read More
How insurance companies police doctors through arcane policies
Insurers never miss a chance to make getting healthcare harder, do they? A new report from Modern Healthcare claims both Horizon Blue Cross Blue Shield of New Jersey and Cigna are planning… Read More
Rural or otherwise, running a hospital is no walk in the park
Running a hospital is serious business. Sure, we can talk theoretically all day about payors, providers, and the pandemonium that is healthcare . . . but the reality of the situation is… Read More
Insurance contract disputes: when the odds are not in patients’ favor
They say all’s fair in love and war. Well, not when it comes to health insurance contract disputes. At least, such is the case for one local community in California. Adventist Health… Read More
Another prior authorization delays patient care and ends in tragedy
OK, we admit it. We’re (fairly) snarky when it comes to health insurance companies. But there’s no room for snark when it comes to a recent Medscape article, which follows the journey… Read More
Health insurers don’t want to cover your care—their chronic denials prove it
In 2020, amid a global pandemic, health insurers on the Affordable Care Act marketplaces denied close to one-fifth of all in-network claims, according to a Healthcare Dive article citing Kaiser Family Foundation… Read More
Aetna sees the light (finally)
Has a health insurer actually seen the harm their restrictive policies cause for patients? According to a recent article in Fierce Healthcare, Aetna is coming to terms with the fact that last… Read More
American Hospital Association begs feds to enforce the law
According to a recent article in Fierce Healthcare, in late May the American Hospital Association (AHA) published a letter to the Department of Justice (DOJ) pleading for an investigation “into commercial payers… Read More
Is anyone getting the mental health coverage they pay for?
How much more evidence do we need? You don’t have to go far to find examples of health insurance companies denying coverage or making it exceedingly difficult to access in-network care. Maybe… Read More
Medicaid expansion: just a bandage for wounds inflicted by NC health insurers
We’ve been sounding the alarm for quite some time now: Rural hospitals struggled before COVID-19. They barely held on during the pandemic. And if private health plans continue to slash reimbursements, rural… Read More
The truth behind hospital costs: rural areas bear the brunt
Health insurers must face the facts — and admit their role in increased rural hospital closures.