Health Populi

MARCH 8, 2023

Many health citizens in the U.S. would likely skip receiving preventive health care services if the Affordable Care Act’s (ACA) coverage for them goes away, a Morning Consult survey found. One of the key benefits embedded in the ACA was “free” without co-pay shares for preventive care.

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Center for Health Insurance Reform

FEBRUARY 10, 2022

Continue reading → The post January Research Roundup: What We’re Reading appeared first on Center on Health Insurance Reforms.

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Health Populi

FEBRUARY 14, 2018

Health insurers in the state are now allowed to offer plans with limited benefits, escaping the rules for plans in the Affordable Care Act that provided for a list of covered benefits. David Cameron, the state’s Director of Insurance, called this strategy, “pushing the envelope” in an interview with NPR last month.

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ACA Health Insurance Hospitals Public Health 81

Health Populi

JUNE 28, 2018

.” For over a year, the KFF polls have tracked that one-half of voters are in favor of the ACA. Health Populi’s Hot Points: What most U.S. health citizens agree on is fairness about health premiums and health insurance access for sick and well people, alike.

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Prescription Drug Pricing ACA Health Insurance Governance 74

Health Populi

APRIL 24, 2018

consumers rank hospitals as the top-trusted segment in the U.S., Otherwise, the news is negative across the remaining four segments: consumer health is the second most-trusted segment, by 56% of Americans, but dropped by 7 percentage points from 2017. Hospitals ranked top in trust among U.S.

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Health Populi

NOVEMBER 19, 2019

In research from HealthPocket , 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. Health insurance costs increased a whopping 20.1%

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Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. No other industry in the U.S.

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Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

Physician Credentialing Company

MAY 16, 2024

They cater to physicians’ practices, hospitals, and integrated delivery systems, allowing healthcare professionals to concentrate on clinical duties and patient outcomes. Two common types of MSO arrangements are Physician-Hospital Organizations (PHOs) and Independent Practice Associations (IPAs).

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Compliance ACA Health Insurance Hospitals 52

Health Populi

JUNE 30, 2023

For this study, PwC conducted 21 surveys and 12 interviews in April through May 2023 among health plan actuaries covering about 100 million employer-sponsored lives and 10 million ACA marketplace members. More patients are coming back to health care, abandoning their personal health mitigation strategy of “medical distancing.”

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Prescription Drug Pricing COVID-19 ACA Hospitals 87

The Digital Health Corner

APRIL 28, 2017

In his testimony on healthcare market’s consolidation effects on quality, cost and access, Paul Ginsberg, Director of Public Policy at the USC Schaeffer Center for Health Policy and Economics cites some key drivers of consolidation. ACOs require scaling which small hospitals cannot provide.

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Hospitals ACA Patient Satisfaction Payment Systems 60

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. HIPAA (1996): The Health Insurance Portability and Accountability Act (HIPAA) established strict standards for patient data privacy and security.

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MedTrainer

JANUARY 26, 2024

healthcare providers – health systems, hospitals and post-acute care facilities – must comply with 629 discrete regulatory requirements across nine domains. At the top of the list is the Health Insurance Portability and Accountability Act (HIPAA).

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HIPAA Compliance ACA Health Insurance 52

Compliancy Group

JANUARY 3, 2024

This mistake resulted in millions of dollars in lost revenue for hospitals. Because many denied claims can be recovered, providers need to follow up within the window of appeal or before the deadline outlined in the insurance payer contract. Many medical bills are unpaid because providers do not promptly follow up on claim denials.

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Medical Billing Compliance ACA Health Insurance 52

Health Populi

SEPTEMBER 5, 2018

The largest patient experience workflows included shopping for health insurance, preparing to see a healthcare provider, connecting with that provider, managing a diagnosis, shopping for services, receiving treatment, and finally, paying for the services. At this moment in U.S.

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Health Insurance Medical Billing Medicaid Medicaid 63

Center for Health Insurance Reform

JUNE 14, 2024

This month we read about the effects of health risk assessments on Medicare Advantage payments, how the Affordable Care Act transformed the healthcare landscape in this country, and finally, about hospital pricing and the values of transparency.

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Health Populi

AUGUST 16, 2019

Examples of these in the current news cycle are Zolgensma, which is priced about $2 million to treat spinal muscular atrophy, and CAR-T therapy which can run as high as $1 million all-in for the treatment and hospital service costs for the patient. Much now depends on the U.S.

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Health Populi

MARCH 15, 2018

varied, with that 10% of health citizens lacking coverage for basic health care. had a higher avoidable hospitalization rate for diabetes and asthma compared with other countries. rated the lowest satisfaction with their health system, where only 19% said the health system orks well. On quality, the U.S.

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Health Populi

JUNE 18, 2018

The bulk of medical costs comprise, Hospital inpatient care (30% of the total medical cost), Prescription medications to treat complications of diabetes (30%), Anti-diabetic agents and diabetes supplies (15%), and, Physician office visits (13%). In the current environment, one in two PwD is already avoiding some care due to costs.

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Health Insurance Hospitals ACA Public Health 54

Center for Health Insurance Reform

JULY 22, 2024

Last month CHIR soaked up the sun and the latest in health policy research. This month we read studies that examined hospital mergers' impact on the economy, reviewed insurance coverage rates during various policy periods, and analyzed the benefits of enhanced premium tax credits.

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Hospitals ACA 52

MedTrainer

JUNE 28, 2023

Health Insurance Portability and Accountability Act (HIPAA). The Affordable Care Act (ACA) also established the Health Care Fraud Prevention and Enforcement Action Team (HEAT) and increased resources for fraud investigations and prosecutions. In addition, the Federal False Statements Act (18 U.S.C.

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YouCompli

AUGUST 9, 2023

From a compliance perspective, this means supporting care teams based on the principles of social determinants of health (SDOH), such as understanding how to access affordable health insurance or obtaining transportation for follow-up appointments.

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Compliance COVID-19 ACA Fraud 52

Healthcare Law Blog

DECEMBER 15, 2022

CMS discusses providers’ concerns that excessive wait times for prior authorization decisions often cause delays to patient care, including transfers between hospitals and post-acute care facilities, treatment, medication, and supplies, and create medical risks in some cases. Timeframes for Decisions and Communications.

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Health Populi

MAY 15, 2019

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. This generation has greater engagement with employers that offer health benefits.

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American Medical Compliance

MARCH 13, 2025

Compliance of Section 1557 of the Affordable Care Act (ACA) reinforces this by prohibiting discrimination and holding healthcare providers accountable for fostering an inclusive environment. Health Insurance Providers : Companies providing health coverage plans. Click here.

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Compliance ACA Patient Satisfaction Medicare 59

Healthcare IT Today

APRIL 10, 2023

By understanding the personalized motivation that each member needs to change behaviors—and by helping train these behaviors into lasting habits—we’ve been able to help people from all walks of life dramatically improve their health outcomes. This saved our customers over $24 million just on hospitalization costs alone.

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Health Populi

OCTOBER 30, 2018

Health Populi’s Hot Points: The vast majority of the most seriously ill patients in the U.S. have health insurance (91%), but even with coverage one-third have serious problems paying hospital bills, and 29% have difficulty affording prescription drugs. healthcare system even more due to complications.

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Health Insurance Medical Billing Public Health Hospitals 88

Compliance Now

JANUARY 13, 2022

The Biden Administration recently announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2023 plan year, as well as the Patient-Centered Outcomes Research Institute (PCORI) Fee for plan or policy years ending on or after October 1, 2021, and before October 1, 2022. This is a $.13

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Kaiser Health News

JULY 6, 2022

. “There are still some gaps that need to be filled,” said Katie Keith, a researcher at the Center on Health Insurance Reforms at Georgetown University. And, if you get a bill from a physician, clinic, or hospital that you think might qualify for no cost sharing, call your insurer to inquire or dispute the charge.

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Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

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Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

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Health Populi

OCTOBER 8, 2019

health care. This challenge covers hospital-acquired conditions and adverse events, clinician-related inefficiency, and lack of adoption of preventive care practices like administering vaccines and addressing obesity and hypertension. That’s the Holy Grail and vision in my book, HealthConsuming: From Health Consumer to Health Citizen.

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Health Populi

MARCH 15, 2021

and more health citizens getting their first jabs, there’s growing optimism in America looking to the next-normal by, perhaps, July 4th holiday weekend as President Biden reads the pandemic tea leaves. But that won’t mean Americans will be ready to return to pre-pandemic health care visits to hospital and doctor’s offices.

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COVID-19 Health Insurance ACA Medicaid 117

Bill of Health

NOVEMBER 9, 2023

has some of the world’s leading medical facilities and research institutions, and the ability to deliver the highest available quality of care, it ranks last among rich nations in providing equitable, accessible, affordable, and high-quality health care. America is the only wealthy nation to lack universal health coverage.

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Healthcare Law Blog

JANUARY 26, 2023

The amendment defines healthcare entity to include any individual physician or other healthcare professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of healthcare facility, organization, or plan.

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AIHC

AUGUST 13, 2024

Written by Corliss Collins , BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC and Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS The 2024 Final Rule for Section 1557 of the Affordable Care Act (ACA) was issued by the Department of Health and Human Services (HHS) on April 26, 2024.

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Compliance ACA Health Insurance Medicaid 52

C&M Health Law

NOVEMBER 23, 2020

On October 29, 2020, the Departments of Health and Human Services, Labor, and the Treasury (“the Departments”) issued a final rule requiring private-sector health insurers and self-insured health plans to disclose treatment prices and cost-sharing information with consumers.

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Regulatory Compliance Hospitals Compliance Health Insurance 40

Health Populi

MARCH 27, 2019

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs.

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