Tag: health insurance

PBMs tend to Dominate State and Local Markets

PBMs tend to Dominate State and Local Markets

Pharmacy benefit managers (PBMs) tend to dominate state and local markets where they provide services to commercial health insurers across the United States. That could mean patients are stuck with higher prescription drug prices, according to new research published by the American Medical Association (AMA). The Policy Research Perspective report, “Competition in Commercial PBM Markets […]
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Hospital Expenses Have Increased 23 Percent Since 2016

Hospital Expenses Have Increased 23 Percent Since 2016

Supply chain issues, medication costs, and labor challenges sparked by the COVID-19 pandemic have contributed to the spiking hospital expenses. Hospital expenses have increased 23 percent since 2016, a spike researchers attributed to continuous COVID-19 challenges, according to a recent analysis. By analyzing American Hospital Association data, investigators noticed hospital expenses increased 47 percent in 2020when […]
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60% of Consumers seek Healthcare Price Transparency

60% of Consumers seek Healthcare Price Transparency

A survey shows that 60% of consumers who look for pricing information seek answers from their insurance companies, but healthcare price transparency should still be a priority for providers. Not many consumers are asking how much healthcare services cost but among those who do, they are seeking answers primarily from their insurance companies, according to […]
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MGMA Requests Updates to Independent Dispute Resolution Portal

MGMA Requests Updates to Independent Dispute Resolution Portal

The organization recommended CMS update the independent dispute resolution portal to improve communication between disputing parties and adjust the form field requirements. The Medical Group Management Association (MGMA) has asked CMS to update the federal independent dispute resolution (IDR) portal to streamline the arbitration process for determining an out-of-network payment rate for a surprise medical […]
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What is the HIPAA Security Rule?

What is the HIPAA Security Rule?

The HIPAA Security Rule requires covered entities and business associates to implement technical, physical, and administrative safeguards. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the HHS secretary to develop rules for safeguarding electronic protected health information (ePHI). Out of these requirements, HHS created the HIPAA Privacy Rule and the HIPAA Security […]
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2022 Medicare Advantage Plan Overview, Part Three_ Social Determinants

2022 Medicare Advantage Plan Overview, Part Three: Social Determinants

  “Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, […]
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Follow these 5 steps to Ensure HIPAA-compliance when texting patients

Follow these 5 steps to Ensure HIPAA-compliance when texting patients

As long as providers remain HIPAA-compliant, they will be able to text patients with ease and see all the benefits that it brings — including stronger patient loyalty, more revenue, and more referrals. Many people, and that includes patients, prefer to text because it’s quick, easy, and convenient. Texting is incredibly effective for medical practices […]
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