Care and Access

North Carolina resident Sally Nix has had enough with prior authorizations. Afflicted with a combination of autoimmune diseases since 2011, brain and spinal surgeries failed to relieve Nix’s chronic pain and fatigue.… Read More

Back in July, the American Hospital Association (AHA) released findings from three surveys conducted by Morning Consult on the practices of commercial health insurers. The findings weren’t great. Patients, nurses, and physicians… Read More

We’ve said it before, and we’ll say it again: Prior authorizations are a bureaucratic bad idea. At least, they are for physicians and patients. But while prior authorizations can be a minor… Read More

Earlier this spring, UnitedHealthcare (United) announced plans to effectively use prior authorizations as blockades to colonoscopies. Any patient seeking a surveillance or diagnostic colonoscopy to detect cancer would first need approval from… Read More

Hospitals are struggling. And according to a new report from the American Hospital Association (AHA), health insurers aren’t doing anything to make it easier. In fact, they’re making it worse. After a… Read More

Like other states, many in North Carolina struggle to access quality healthcare. Several bills are in review by the state’s House Health Committee, many of which seek to improve access for patients… Read More

FINALLY! North Carolina expanded Medicaid. After years of debate across the state, after months of pushing and pulling on both sides of the aisle, North Carolina Republicans finally passed Medicaid expansion. It’s… Read More

1.2 seconds. That’s how long it takes for ‘an expert’ at Cigna to look at your medical claim and determine the fate of your care. A whopping 1.2 seconds. They do it… Read More

Every few years, contract negotiations between payors and providers pull back the curtain on the innerworkings of the American healthcare system. The findings are gruesome. For reference, a recent article in Becker’s… Read More

You’re probably familiar with the phrase, “The road to hell is paved with good intentions.” The same can be said of prior authorizations. Decades ago, prior authorizations were designed with a reasonable… Read More

Between 2018 and 2021, Wilmington, North Carolina resident Stephanie Christy was covered under an individual health plan sponsored by Blue Cross Blue Shield of North Carolina (BCBSNC). Until she wasn’t…and was left… Read More

Let’s be real: Insulin is already expensive. A 2021 RAND report found that insulin costs approximately 10 times more for Americans than it does in other countries. So, we don’t need drug… Read More

Chronic conditions, such as diabetes, require management, care, and medications. When insurers create hurdles that directly or indirectly block access to care, those patients suffer. And apparently, that’s exactly what’s happening across… Read More

We’ve come a long way in modern medicine, especially when it comes to HIV care. In the mid-90s, life expectancy at age 20 for HIV-infected individuals was just 39 years old. Today,… Read More

It’s the holiday season, a time for peace and goodwill, right? Well, not quite. Because it’s also the season for contract negotiations, err . . . disputes. And it looks like insurers… Read More

Over the past year, hospitals across the nation have experienced a rise in denied medical claims from insurance companies. According to a recent article in Modern Healthcare, approximately 67% of healthcare leaders… Read More

According to a recent poll conducted by Raleigh-based Meredith College, most North Carolinians don’t believe their health insurance provider has their best interest in mind. For some of you, this might seem… Read More

That payor-provider gap? It’s becoming an abyss. At this point, it’s clear that the U.S. healthcare system is simply breaking down — with billions of dollars being funneled toward insurance company shareholders,… Read More

Contract negotiations are nothing new – hospitals and insurance companies renegotiate their rates for services regularly. But the trend of the last few years is upped aggression from payors, where networks are… Read More

Here’s the good news: The number of Americans with health insurance is hitting historic highs. And the bad news: The health insurance itself is inadequate. According to recent findings from the Commonwealth… Read More

The future of mental health coverage parity remains uncertain, according to a recent article from Axios. But it’s not for lack of trying. For the upcoming legislative session in February, the Senate… Read More

It’s an unfortunate ending for California patients – a utilization management bill successfully passed the state Assembly and Senate, just to be vetoed by Governor Gavin Newsom. Sponsored by California Assembly member Dr.… Read More

Rural hospitals are literal lifelines for the communities they serve. And yet, they keep closing across the country. A new report from the American Hospital Association (AHA) is sounding the alarm, as… Read More

We all (unfortunately) know that getting your care covered by insurance is anything but simple. And for families with children with autism spectrum disorder, insurers like Trustmark Health Benefits make the process… Read More