Tag: Insurance

Rethinking life after 65: A three-pillar approach to retirement planning

Editor's Note With several major gatherings planned for this spring—including those from AORN, AONL, ASCA, and ASPAN—a bustling events season offers perioperative leaders valuable opportunities for reflection on our careers and futures. Speaking of futures, the 2024 OR Manager Salary/Career Survey revealed an intriguing shift: only 9% of perioperative nurses…

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By: Rosemary Welde, RN, MBA, BCC
March 5, 2025
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Cost-shifting concerns rise as GOP eyes Medicaid cuts

Editor's Note Large employers are warning hospitals they will not absorb higher costs if plans by Republicans and the Trump administration for deep Medicaid cuts proceed, a February 28 article in Modern Healthcare reports. The threat of reduced Medicaid funding has reignited concerns about hospitals shifting costs onto employers and…

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By: Matt Danford
March 3, 2025
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Study: Wildfire smoke raises hospital borrowing, patient care costs

Editor's Note Wildfire smoke is driving up borrowing costs for hospitals and healthcare facilities, potentially leading to higher patient care costs, according to new research from the University of Nevada, Reno. As detailed in a February 18 article in Nevada Today, findings show municipal bond investors are factoring wildfire smoke…

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By: Matt Danford
February 25, 2025
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Montana legislators' prior authorization reform push mirrors national trends

Editor's Note Montana legislators are moving to restrict health insurers’ use of prior authorization as frustration over the practice mounts nationwide, KFF News reported February 13. The outlet reports that two Democratic and Republican lawmakers have introduced or are drafting bills for the 2025 Montana Legislature to limit these insurer-mandated…

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By: Matt Danford
February 18, 2025
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Rural hospital closures drive up surgical travel times and costs

Editor's Note Ongoing hospital closures are driving up travel times and out-of-pocket costs for rural Americans who need surgery, according to a February 12 report in HealthDay. Citing two recent studies published in Annals of Surgery and JAMA, respectively, the article details how rural hospital closures have forced more patients…

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By: Matt Danford
February 14, 2025
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Moody’s downgrades health insurance outlook as medical costs surge

Editor's Note Moody’s Ratings has shifted the health insurance industry’s credit outlook from stable to negative, according to a February 3 article in Fierce Healthcare. According to the article, the downgrade is due to escalating medical costs that outpace reimbursement rates. Analysts project an 8% rise in commercial market spending…

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By: Matt Danford
February 5, 2025
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Cigna ties executive pay to patient experience

Editor's Note As part of a larger initiative to ease access to care, insurance giant Cigna is tying compensation for senior leadership directly to customer satisfaction. Modern Healthcare reported the news February 3. The shift is part of a multi-pronged approach that also includes overhauling prior authorization requirements and limiting…

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By: Matt Danford
February 4, 2025
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Providers push back on insurance cost-cutting hurdles

Editor's Note Escalating administrative hurdles from insurers are heightening tensions between healthcare payers and providers who criticize the measures for threatening patient care, Modern Healthcare reported January 22. According to the article, policies attracting criticism include stringent prior authorization rules, claims denials, and new fees for appeals. For their part,…

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By: Matt Danford
January 23, 2025
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Prosthetic insurance coverage disparities persist despite legal protections

Editor's Note Health insurance coverage of prosthetics remains inconsistent and often inadequate, KFF Health News reported January 6. As a result, many patients face coverage denials due to claims of lack of medical necessity or high costs despite significant advancements in prosthetic technology, such as microprocessor-controlled knees and myoelectric hands.…

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By: Matt Danford
January 9, 2025
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Surgical legislation advocacy focuses on safety, access

“Surgeons are the only people trained to provide surgery—life-saving care," says Carrie Zlatos, chief of legislative and political affairs at the American College of Surgeons (ACS). "They are an essential element of a community-based healthcare system. Regardless of where you live, everyone should have access to full quality surgical care.”…

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By: Brita Belli
January 1, 2025
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