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Put up your dukes. Insurers are coming out swinging.

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

More people are covered by health insurance – but health insurance covers less

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

Can the feds finally make mental health parity a reality? Here’s hoping…

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

Another way insurance regulation benefits health insurers — not patients

We’ve written many times about how profitable Medicare Advantage plans have been for insurance companies. In part, it seems because they are excellent at taking regulations intended to benefit consumers and managing… Read More

California governor shoots down bill to protect patient access

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 necessary. So why do they keep closing?

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

A picture’s worth a thousand words. For health insurers, it’s worth millions.

You know that $100+ premium you pay each month to ensure you have health insurance? Or maybe it’s more like $500+? For the really unlucky, it could even be $1,000+! Turns out,… Read More

Need medical care? Better prove it.

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

Hey North Carolina, where’s the outrage on insurance increases?

Only in the insurance industry can a business secure a $500 million-dollar profit and demand that consumers pay more. According to a September 1 article published in North Carolina News, Blue Cross… Read More

The real reason for North Carolina’s mental health crisis

When health insurers stand in the way of preventive mental healthcare, the results can be dire. Though they are supposed to cover mental healthcare on par with physical healthcare services, the reality… Read More

No kidding: Americans dissatisfied with health insurance plans

Well, well, well . . . if it isn’t the pot calling the kettle black. A new poll revealed that most American consumers are dissatisfied with their health insurance plans. You don’t… Read More

With big premium bumps, Northeastern consumers may be facing a frigid financial future

We’re not saying we told you so, but we are saying we saw this coming. Health insurance premiums are up nearly 14%, and consumers across the States are already facing inflated insurance… Read More

Hospital outlooks? ‘Deteriorating.’ Payor predictions? ‘Attractive returns.’

Bad news for nonprofit hospitals (and just after things were maybe looking up!). Ratings agency Fitch Ratings published a new outlook for the nonprofit hospital sector, and it’s anything but encouraging. In… Read More

We’ve made it another half-year. Guess which health insurer is in the lead (again).

We’ve made it another half-year. Guess which health insurer is in the lead (again). Another earnings season, another unfathomably large profit for our nation’s largest health insurance company (and the rest aren’t… Read More

How insurance companies police doctors through arcane policies

Insurers never miss a chance to make getting healthcare harder, do they? A new report from Modern Healthcare claims both Horizon Blue Cross Blue Shield of New Jersey and Cigna are planning… Read More

Hospitals may catch a break in insurer negotiations (but we’re not holding our breath)

Dare we say we have . . . good news? Could it be that payers are finally acknowledging how expensive it is to operate a hospital? According to a recent article in… Read More

Rural or otherwise, running a hospital is no walk in the park

Running a hospital is serious business. Sure, we can talk theoretically all day about payors, providers, and the pandemonium that is healthcare . . . but the reality of the situation is… Read More

Insurance contract disputes: when the odds are not in patients’ favor

They say all’s fair in love and war. Well, not when it comes to health insurance contract disputes. At least, such is the case for one local community in California. Adventist Health… Read More

Another prior authorization delays patient care and ends in tragedy

OK, we admit it. We’re (fairly) snarky when it comes to health insurance companies. But there’s no room for snark when it comes to a recent Medscape article, which follows the journey… Read More

TeamHealth and UnitedHealthcare get in the ring . . . again

Does a Nevada lawsuit with UnitedHealthcare (United) sounds familiar? Well, since TeamHealth filed ten lawsuits against UnitedHealth Group last December, alleging underpayment for TeamHealth physicians – it might! In the first case,… Read More

Health insurers don’t want to cover your care—their chronic denials prove it

In 2020, amid a global pandemic, health insurers on the Affordable Care Act marketplaces denied close to one-fifth of all in-network claims, according to a Healthcare Dive article citing Kaiser Family Foundation… Read More

Optum takes its joint ventures to the next (vertical) level

Is there any type of business that health insurance giant UnitedHealth Group won’t try to stick a flag in? Per a July 11 article in Modern Healthcare, UnitedHealth’s massive physician group, Optum,… Read More

Connecticut AG pushes back on health plan premium hikes – again

Summer in New England is quite nice – our Northeastern friends often enjoy somewhat cooler temps than the rest of the country. Unless you’re an insurance plan, in Connecticut. Then you’re (appropriately)… Read More

Will new federal rules bring health insurers’ shady negotiation tactics to light?

It’s finally here – after wrangling substantially more time to prepare than hospitals had, insurers are now required to post their negotiated prices publicly on their websites. According to Fierce Healthcare, the… Read More

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Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.