Stefanie Randall

THE AHA ISSUES REPORT SHOWING FINANCIAL PRESSURES ON HOSPITALS DUE TO INCREASED COSTS AND INADEQUATE REIMBURSEMENTS

The American Hospital Association has issued a Costs of Caring Report showing increased costs to hospitals and health systems coupled with inadequate payer reimbursement creating “an environment of financial uncertainty where many hospitals and health systems are operating with little or no margin.” Among the highlights of the Report are the following: Hospitals’ labor costs, […]

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HUMANA REPORTS STRONG FIRST QUARTER 2024 PROFITS AND REVENUES BEATING ANALYSTS’ EXPECTATIONS

Humana, Inc. has reported strong first quarter 2024 profits of $741 million.  Humana also posted strong first quarter revenues of $29.6 billion, up from $25 billion in the prior year quarter. Humana’s first quarter profits and revenues both exceeded analysts’ expectations. Humana reported $28.7 billion in revenue in its insurance segment, due in part to

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NYT VIDEO OPINION DEMONSTRATES HOW INSURANCE COMPANIES USE PRIOR AUTHORIZATION TO CAUSE DANGEROUS DELAYS IN PATIENT CARE

The New York Times has published a video opinion entitled “What’s My Life Worth? The Big Business of Denying Medical Care,” which illustrates how “profit-seeking insurance companies” use the prior authorization process “to create intentional barriers between patients and the healthcare they need.”  As stated in the video: “At best, it’s just a minor bureaucratic

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STUDY FINDS THAT MEDICARE ADVANTAGE PATIENTS RECEIVE LESS HOME HEALTH CARE THAN PATIENTS WITH TRADITIONAL MEDICARE

A study recently published in JAMA Health Forum found “significant differences in home health service intensity” between patients enrolled in Medicare Advantage plans and patients enrolled in traditional Medicare. The study was entitled “Differences in Home Health Services and Outcome between Traditional Medicare and Medicare Advantage.” Some of its key findings were: Medicare Advantage patients

STUDY FINDS THAT MEDICARE ADVANTAGE PATIENTS RECEIVE LESS HOME HEALTH CARE THAN PATIENTS WITH TRADITIONAL MEDICARE Read More »

THE DEPARTMENT OF JUSTICE REPORTS FALSE CLAIMS ACT RECOVERIES AGAINST MEDICARE ADVANTAGE PLANS IN FISCAL YEAR 2023

The United States Department of Justice has issued a report listing the settlements and judgments it reached under the False Claims Act for Fiscal Year 2023.  The report includes settlements with Medicare Advantage plans in cases alleging that the plans for knowingly submitting inaccurate information regarding the health status of their beneficiaries to increase their

THE DEPARTMENT OF JUSTICE REPORTS FALSE CLAIMS ACT RECOVERIES AGAINST MEDICARE ADVANTAGE PLANS IN FISCAL YEAR 2023 Read More »

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