Survey assesses continued impact of Change Healthcare cyberattack
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…
Concierge physician practices expanding to large hospitals
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…
Private payers profit by delaying medical claims
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…
How data puts the ‘value’ in value-based care
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…
Alabama immunity legislation shields IVF patients, providers
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…
Hospital hacking threats persist amid continued chaos of Change Healthcare cyberattack
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…
Coordinating surgical care means precise staff handoffs
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…
Doctors with multiple malpractice suits become insurance company medical directors
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…
A closer look at variations in regional health insurance prices
Editor's Note This new study in JAMA Health Forum is one of the first to review publicly available insurer price data and compare regional rate differences. The research was published by JAMA Network on October 27. Following are some highlights: Over half of the US population receives health insurance from…
Problems with prior authorization, utilizing health insurance coverage are prevalent, survey finds
Editor's Note This KFF survey from June 2023 found that some six in 10 adults with health insurance have experienced problems when trying to use their insurance, KFF Health News September 29 reports. The problems included denied claims, network adequacy issues, and preauthorization delays and denials. According to the survey,…
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