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Unnecessary Healthcare Services Cost Colorado Patients and Insurers $134M in 2021
New analysis of low value care in the state looks at utilization and how it affected spending.
Medicaid Managed Care Has High Rates of Prior Authorization Denials
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically...

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Industry Groups in California Vie for New Medicaid Money
Top state health officials say they plan to plow most of the money into higher payments for doctors, hospitals, and...
The Exec: Elizabeth Mitchell Has a Message from U.S. Employers
The Purchaser Business Group on Health executive signals how far employers are willing to go to tame out-of-control healthcare costs.
Elevance Health Nets $1.9B in Profits in Promising Q2
The payer saw "encouraging" signs that Medicaid members losing coverage are transitioning into Affordable Care Act (ACA) exchange plans.
CMS Plans to Crack Down on Price Transparency Compliance in 2024
Price transparency adherence may become more complex in 2024.
Mobile Health Apps Can Be a Valuable Tool for Providers and Patients, But Regulation Issues Persist
Liz Ashall-Payne, the founder and CEO of ORCHA, an international effort to establish digital health standards, explains why mHealth apps...
Industry groups in California vie for new Medicaid money
California's powerful health care industry just notched a historic win: The state is going to give it an $11.1 billion...
Molina Healthcare has highest denial rate for Medicaid recipients, report says
More than 86.7 million low-income Americans rely on Medicaid for their health care, but private insurance companies are denying millions...
Negotiations begin in proposed sale of St. Mary's Medical Center to UCSF
The sale of one of the Bay Area's oldest operating hospitals to UCSF is moving forward as the UC Board...
Doctors created a primary care clinic as their former hospital struggled
As of July 11, 195 rural hospitals have shuttered inpatient units or closed their doors altogether in the United States...
New 2024 CMS proposal includes almost 3.4% cut in Medicare physician fees
As part of the calendar year (CY) 2024 Physician Fee Schedule Proposed Rule and other Medicare Part B issues, CMS...
Orlando Health patients may lose UnitedHealthcare coverage amid stalled contract dispute
Thousands of UnitedHealthcare members in Central Florida may soon lose access to in-network care at Orlando Health amid stalled contract...
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