Evidence

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

It’s another loss for UnitedHealthcare (United) in its ongoing legal battle with TeamHealth. The Tennessee-based emergency physician company has filed a total of ten lawsuits against UnitedHealth Group, but its most recent… Read More

It’s ironic, isn’t it? When hospitals, who are on the verge of closure following a brutal pandemic, decide that partnering with other providers is the only way to keep their doors open,… Read More

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

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

Brace yourself: Health insurance prices will be higher next year. Word on Wall Street is that health insurance companies are set to raise prices next year faster than medical costs are increasing,… Read More

According to a recent article in the New York Times, by next year, half of Medicare beneficiaries will have a privately operated Medicare Advantage (MA) plan. Seems innocuous enough. But wait, there’s… Read More

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

The artist formerly known as ‘Anthem’ can’t escape its legal woes. You may remember back in 2020 when the health insurer paid $594 million toward the Blue Cross Blue Shield Association antitrust… Read More

It’s been a while since we’ve talked about Humana. But this one is big. According to a September 2022 article in Fierce Healthcare, Humana is pumping $500 million into primary care clinics,… Read More

Showers are forthcoming. Maybe even thunderstorms, by the look of it. According to a recent article in Becker’s Payer Issues, UnitedHealth Group (UHG) reported third-quarter revenue growth in the double digits across… Read More

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

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

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

We’ve written many times about how profitable Medicare Advantage plans have been for insurance companies. In part, it seems because they are excellent at taking regulations intended to benefit consumers and managing… Read More

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 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

You know that $100+ premium you pay each month to ensure you have health insurance? Or maybe it’s more like $500+? For the really unlucky, it could even be $1,000+! Turns out,… Read More

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

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

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

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

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

Bad news for nonprofit hospitals (and just after things were maybe looking up!). Ratings agency Fitch Ratings published a new outlook for the nonprofit hospital sector, and it’s anything but encouraging. In… Read More