Prior authorization denials vary widely among insurers, first-of-its-kind data shows
Denials ranged from 2% to 25% among insurers last year, according to a KFF analysis of new prior authorization data that the CMS forced insurers to release.
Why the first 24 hours after discharge matter for star ratings
Why leading Medicare Advantage plans are rethinking care transitions.
Premiums, out-of-pocket costs dominate Americans’ healthcare concerns: survey
Respondents were split on who should solve the issues, with Democrats more likely to say the federal government and Republicans more likely to name insurers, according to a survey from the Commonwealth Fund.
CHAI creates work group to counter frontier AI model cybersecurity risks
CHAI plans to create playbooks to help organizations defend against — and leverage — these powerful systems.
5th Circuit strikes down No Surprises billing benchmark in win for providers
The court ruled Tuesday that insurers can’t include ghost rates or exclude bonus payments in calculating a metric used to determine reimbursement for out-of-network bills. That’s set to further inflate payouts to providers.
Health advocacy group sues AMA to make billing codes public
PatientRightsAdvocate.org is challenging the doctor’s association’s copyright of the current procedural terminology, or CPT, system. Use of the codes is required by law, and that means they should be freely available, per the suit.
Nonprofit hospital recovery may have peaked, Fitch warns
The sector’s overall operating margin improved in 2025, but some providers lost ground as major federal funding cuts loom.
Rural communities bear the brunt of healthcare workforce shortage: report
With the U.S. already facing a deficit of 86,000 physicians by 2036, healthcare cuts could push more rural hospitals to the brink of closure, according to a new study from staffing firm AMN healthcare.
Healthcare CFOs face decision readiness gap: Deloitte
The findings could reflect a “mismatch” between expanding expectations for CFOs and the support systems available to finance teams, Deloitte said.
Trump administration cuts Medicaid funding for youth gender-affirming care
CMS Administrator Dr. Mehmet Oz argues the rule will protect children from “irreversible harm.” LGBTQ+ advocates say it’s an attack on transgender youth.