Providers say claims denials are increasing: survey
Health Care Dive
SEPTEMBER 25, 2024
Nearly three in four providers surveyed by Experian Health said the number of claims denied by payers shot up between 2022 and 2024.
Health Care Dive
SEPTEMBER 25, 2024
Nearly three in four providers surveyed by Experian Health said the number of claims denied by payers shot up between 2022 and 2024.
Fierce Healthcare
SEPTEMBER 25, 2024
While consumers give telehealth high marks for convenience, overall experience is fairly mixed, according to a new report. | While consumers give telehealth high marks for convenience, overall experience is fairly mixed, according to a new report.
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Healthcare It News
SEPTEMBER 25, 2024
Nearly two-thirds (66%) of U.S. patients with sensitive health issues are more comfortable making appointments with chatbots than with staff, according to the Talkdesk U.S. Consumer Healthcare Survey, conducted in August 2024 on the online platform Pollfish. Talkdesk received responses from 1,000 men and women aged 18 and over. Meanwhile, 62% of patients felt support provided by their healthcare organizations has either worsened or remained stagnant in the past year, the survey found.
Fierce Healthcare
SEPTEMBER 25, 2024
Democratic lawmakers are pushing to make the Affordable Care Act’s (ACA's) enhanced premium tax credits permanent through the newly reintroduced Health Care Affordability Act. | Extending the ACA premium tax credits permanently is broadly popular among a broad coalition of supporters due to the subsidy's ability to provide access to healthcare and keep costs low.
Speaker: Dr. Christine Gall, DrPH, MS, BSN, RN
The promise of virtual care is no longer theoretical and is now a critical solution to many of healthcare’s most urgent challenges. Yet many healthcare leaders remain unsure how to build a business case for investment and launching the right program at the right time can be the difference between value and failure. For organizations seeking a financially sound, clinically effective entry point, Virtual Patient Observation (VPO) offers a compelling case to lead with.
Health Care Dive
SEPTEMBER 25, 2024
Regulators say Medicare needs more data and oversight to avoid fraud and misuse. Digital health advocates argue the service is still crucial for managing chronic conditions.
Fierce Healthcare
SEPTEMBER 25, 2024
Startup Medicare Advantage insurer Zing Health banked a $140 million funding round it intends to use to enhance its special needs plans. | Startup Medicare Advantage insurer Zing Health banked a $140 million funding round it intends to use to enhance its special needs plans.
Health Care Quality Digest brings together the best content for healthcare quality professionals from the widest variety of industry thought leaders.
Fierce Healthcare
SEPTEMBER 25, 2024
Recent survey and system data are again suggesting that payers’ increasing claims denials are a pain point for healthcare providers. | A new revenue cycle leadership survey from Experian Health, monthly dashboard updates from Kodiak Solutions and other recent commentary paint a picture of more demanding payers.
Health Care Dive
SEPTEMBER 25, 2024
CEO Lars Fruergaard Jørgensen told lawmakers the company would consider new talks with insurers about the list prices of Wegovy and Ozempic if they pledge to keep the medicines on their formularies.
Fierce Healthcare
SEPTEMBER 25, 2024
The nonprofit hospital sector’s tax exemptions provide billions in estimated benefits, but about half of those exemptions are enjoyed by just a couple hundred hospitals, according to a newly publis | The analysis, meant to serve as a guide for policymakers, noted that the tax breaks are "highly concentrated" and vary "substantially" from state to state.
Healthcare It News
SEPTEMBER 25, 2024
Are you exploring how your organization can best leverage AI tools? If you weren’t able to attend this year’s HIMSS AI in Healthcare Forum, catch up on the highlights in this podcast. Join Chris Gervais, Chief Technology Officer at CodaMetrix, to hear about use cases for AI and to get insights into how companies can leverage these technologies to improve staff and patient experiences, enhance efficiency and drive long-lasting value.
Speaker: Brian Richardson, Brian Richardson, Founder and CEO of Richardson Consulting Group
Let’s face it—most ethics and compliance training programs aren’t winning awards for engagement. But that doesn’t mean they can’t be effective, captivating, and maybe even enjoyable! Join learning design expert Brian Richardson for a dynamic session on how to breathe new life into your ethics and compliance training. We'll explore innovative strategies to bring traditionally dry topics to life, making them resonate with learners and drive tangible change.
Health Care Dive
SEPTEMBER 25, 2024
The funds will go toward expanding substance use disorder treatment and maternal healthcare services, as well as helping rural hospitals keep their doors open.
Fierce Healthcare
SEPTEMBER 25, 2024
Certain cancer rates are on the rise, and outcome inequities remain a major public health | In this week's "Podnosis," Fierce Healthcare’s Anastassia Gliadkovskaya talks to BrightEdge’s Alice Pomponio about investing in cancer-fighting startups and measuring impact.
Health Care Dive
SEPTEMBER 25, 2024
The home health aide provider allegedly terminated the assignments of Black and Hispanic aides to accommodate patients’ and family members’ racial preferences, the Equal Employment Opportunity Commission said.
HIT Consultant
SEPTEMBER 25, 2024
Chief Clinical Innovation Officer, Access TeleCare For decades, one of the most daunting tasks in healthcare has been managing and making sense of the vast amounts of data generated annually. From patient and outcomes data to billing and scheduling data, the list goes on and on. The predominant challenge lies not just in quantity but like this data: much if not most of it is unstructured, i.e., data that isn’t predefined and searchable on a table, such as text messages, images, videos, audio fil
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Home Health Care
SEPTEMBER 25, 2024
This article is a part of your HHCN+ Membership Hospital at Home (HaH) is a sustainable, innovative and next-generation health care model. From the physician’s perspective, it offers person-centered medical care and keeps patients out of the hospital, away from possible complications and on to better outcomes. However, there are still plenty of challenges for providers to work through.
HIT Consultant
SEPTEMBER 25, 2024
MJ Stojak, Managing Director of the Data, Analytics and AI Practice for Pivot Point Consulting Much has been discussed about artificial intelligence (AI) and the impressive proliferation of Generative AI (GenAI) over the last several months. It is staggering. As I think about the potential changes and impacts of leveraging AI and GenAI within a healthcare organization, I can’t help but think about the good, the bad, and the ugly.
Home Health Care
SEPTEMBER 25, 2024
Having an eye towards growth also means being aware of potential roadblocks that could obstruct forward momentum. Home care leaders at companies like Comfort Keepers, Nova Leap and TheKey are navigating various barriers amid their efforts to further scale. At Comfort Keepers, the Ensuring Access to Medicaid Services rule is top of mind. Specifically, the rule’s 80-20 provision, which requires providers to earmark 80% of reimbursement for home- and community-based services (HCBS) to caregiver wag
Life Qi
SEPTEMBER 25, 2024
In this article we're helping you to find out where to focus your quality improvement efforts showcase some real-life examples from leading organisations.
Speaker: Amie Phillips Pablo, VP, Corporate Compliance & Privacy Officer at Novo Nordisk
In today’s complex healthcare environment, navigating third-party relationships has become even more challenging—whether it’s vendor relationships, employee activities, or patient-facing interactions. Left unmanaged, these conflicts can compromise trust, regulatory compliance, and even organizational reputation. So, how can healthcare teams stay ahead?
Home Health Care
SEPTEMBER 25, 2024
The Future Leaders Awards program is brought to you in partnership with Homecare Homebase. The program is designed to recognize up-and-coming industry members who are shaping the next decade of home health, hospice care, senior housing, skilled nursing, and behavioral health. To see this year’s Future Leaders, visit [link]. Sarah Jacob, chief product officer at MedBridge, has been named a 2024 Future Leader by Home Health Care News.
HIT Consultant
SEPTEMBER 25, 2024
What You Should Know: – Mount Sinai Health System , a leading U.S. healthcare provider, and Noom , a pioneer in digital health and chronic disease prevention, have joined forces to offer patients a comprehensive approach to achieving and maintaining a healthy weight. – The partnership aims to bridge the gap between doctor visits by providing patients with continuous digital support for behavior change while keeping their physicians informed of their progress.
HIStalk
SEPTEMBER 25, 2024
News The New York Times covers physician use of Epic’s.
Health Populi
SEPTEMBER 25, 2024
Lululemon has published the 2024 Global Well-Being Report , a study into peoples’ perspectives on their personal health from the company best known for athleisure wear and self-care. This year’s report is titled, The Pressure to Be Well. That pressure is coming from peoples’ experiencing “well-being burnout.” In the company’s fourth annual report on well-being, Lululemon learned that most people have tried to adopt personal strategies to bolster their health, and one-half of th
Speaker: Jennifer Hill
Payroll compliance is a cornerstone of business success, yet for small and midsize businesses, it’s becoming increasingly challenging to navigate the ever-evolving landscape of federal, state, and local regulations. Mistakes can lead to costly penalties and operational disruptions, making it essential to adopt advanced solutions that ensure accuracy and efficiency.
Healthcare ECONOMIST
SEPTEMBER 25, 2024
This questions may be harder to answer than it may seem. While some physicians are fully independent, and others are full employees, other physicians can be affiliated with hospitals, without being hospital-employed. There are various approaches for measuring whether a physician is integrated within a hospital system: Basic TIN-based measure. The standard approach to identifying whether a physician is integrated into a hospital is to examine whether that physicians billed exclusively or primaril
HIT Consultant
SEPTEMBER 25, 2024
What You Should Know: – Qure.ai , a prominent global innovator in healthcare AI, has successfully closed a $65M in Series D funding round led by Lightspeed and 360 ONE Asset , with contributions from Merck Global Health Innovation Fund and Kae Capital. The round also included participation from existing investors, including Novo Holdings , HealthQuad , and TeamFund. – This substantial investment will accelerate the company’s expansion into the US market and other regions, boost
Meditech
SEPTEMBER 25, 2024
Today’s EHRs are more than just patient records. They are powerful and intelligent decision-making tools that clinicians rely on daily to make the best decisions for their patients and their healthcare organizations. But what makes an EHR intelligent?
HIT Consultant
SEPTEMBER 25, 2024
What You Should Know: – Zing Health , a trailblazing Medicare Advantage insurer, has announced a successful $140M funding round. The round includes participation from Health 2047 Capital Partners , CRG , and First Trust Capital Partners , alongside existing investors Newlight Partners , Town Hall Ventures , Health 2047 , and Leavitt Equity Partners. – The investment will fuel the expansion of Zing Health’s integrated, chronic special needs-focused plans to reach more beneficiar
Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.
The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven
HIStalk
SEPTEMBER 25, 2024
Global healthcare AI innovator Qure.ai completes $65 million Series D.
HIT Consultant
SEPTEMBER 25, 2024
What You Should Know: – Edifecs and HealthEdge , two leading healthcare technology companies, have announced a strategic partnership to natively integrate Edifecs’ EDI Gateway offerings with HealthEdge’s HealthRules Payer claims adjudication system. – This partnership will enable organizations to confidently navigate complex regulatory landscapes while also laying the foundation for future advancements in healthcare administration.
Bill Of Health
SEPTEMBER 25, 2024
By Zack Buck Yet another case that examines the authority of administrative agencies to interpret health care laws will make its way to the Supreme Court next term. And the case could have major implications for hospital financing as well. In June 2024, the U.S. Supreme Court granted cert in Advocate Christ Medical, et al. v. Becerra , a case that centers on the appropriate calculation of so-called disproportionate share hospital (DSH) payments, which are made to hospitals that treat a high perc
HIT Consultant
SEPTEMBER 25, 2024
What You Should Know: – Pomelo Care , a provider of evidence-based maternity care, has acquired The Doula Network , the largest network of credentialed, in-network doulas in the United States. – The acquisition expands Pomelo’s reach to over 15 million covered lives, including more than 1 in 6 Medicaid beneficiaries nationally. By integrating doula care into its evidence-based, hybrid care model, Pomelo is expanding access to high-quality care, improving outcomes for mothers
Speaker: Kaitlin Ruby Carroll
Retaining top talent in 2025 means rethinking benefits. In a competitive job market, fertility benefits are more than just offerings - they are a commitment to your team’s well-being. Gain critical insights into the latest fertility benefits strategies that can help position your organization as an industry leader. Our expert will explore the unique advantages and challenges of each model, share success stories from top organizations, and offer practical strategies to make benefits decisions tha
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