Editor's Note Average prices for healthcare services trended upward from 2018 to 2022 despite fluctuations in utilization of service, according to the annual Health Care Cost and Utilization Report (HCCUR) from the Health Care Cost Institute (HCCI). In the same timeframe, per-person spending increased nearly 19%. "Prices, in particular, pose a…

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Editor's Note Personal information about a “substantial portion of people in America” could be at risk from the February 21 cyberattack on UnitedHealth’s Change Healthcare division, The Associated Press reported April 23. Although the company reports no signs of full medical histories or charts were released, notifying all who were…

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Editor's Note Fallout from the February 21 cyberattack on Change Healthcare continues to threaten physician practices and their patients nationwide, with respondents to a recent American Medical Association (AMA) survey indicating difficulties with insurance claims and eligibility verification. AMA published the results of the informal survey April 10. Conducted March…

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Editor's Note The practice of concierge physicians is expanding as thousands of doctors at large hospital systems shift to a model facilitating high fees and decreased patient load, according to an April 1 report in KFF Health News. The concierge physician model began decades ago in wealthy areas of Florida…

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Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…

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What if a surgeon decided to perform a procedure on a patient that was not totally necessary? It happens more often that one might realize. As recently as August 2023, Forbes published an article that cited a Harvard Business Review report stating that over 50% of lumbar spine surgeries are…

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Editor's Note A new Alabama law provides civil and criminal immunity for providers and patients of in vitro fertilization (IVF) services, the Associated Press reported March 7. Last month, the Alabama Supreme Court effectively ruled that frozen embryos are people with a constitutional right to life, casting doubt on the…

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Editor's Note The ransomware group behind a recent cyberattack on one of the nation’s largest health systems has its sights set on hospitals, the FBI and the Department of Health and Human Services (HHS) warned February 27. According to a report in Chief Healthcare Executive one day later, systems were…

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In every OR, the complicated dance of surgical care coordination—the series of handoffs between stakeholders throughout the surgery lifecycle—is performed mainly in the background. Those stakeholders include physician offices, schedulers, preadmission testing, insurance verification, vendors, sterile processing, supply chain, anesthesia, and surgical staff. But what does it look like when…

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Editor’s Note An investigation by the nonprofit organization ProPublica and the Capital Forum revealed many doctors with a history of malpractice cases now serve as insurance company medical directors—a role with major influence on decisions that impact patient outcomes. According to a December 15 article in ProPublica, the organizations used…

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