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Low-income patients face uphill battle when fighting health insurance denials, Umass research finds

Medical Economics

adults with private health insurance between 2017 and 2019. Another finding: about 40% of all denials were due to billing errors by health care providers or processing mistakes by insurers—a reminder that many denials are not based on medical necessity or policy rules, but administrative mishaps.

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April 2025 Healthcare Data Breach Report

The HIPAA Journal

CA Health Plan 12,224 Unauthorized Access/Disclosure Mailing incident involving mailing vendor (Billing Documents Specialists) Shipping labels contained Social Security numbers. Those vulnerabilities were exploited by a threat actor who accessed its PACS for 9 months between April 2019 and January 2020. PIH Health, Inc.,

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What is the real cost of the care you provide?

Physicians Practice

Dr. Baum has published a book, The Business Basics of Building and Managing a Healthcare Practice, (Springer 2019), which emphasizes the importance of being involved in the business of a medical practice. Recent Videos Related Content 8 Fourth of July prep steps for your practice Keith A.

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National Health Spending in the U.S. in 2033: What 20.3% of the GDP Will Be Spent On

Health Populi

This growth will be happening as CMS projects coverage of insured people to decline over the period. Note that Health Affairs ‘ sub-title for the study’s release today was, “despite insurance coverage declines, health to grow as share of GDP.” For the U.S.

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Managed Care History Part III: The Rise of Machine-Driven Managed Care

The Healthcare Blog

If you missed it read Part 1 & Part 2 By JEFF GOLDSMITH Two major changes in health insurance ensued as the US health system entered the 21 st century- a strategic shift of health cost risk from providers to patients and the emergence of machine driven managed care. Some 60% of hospital bad debts are now from patients with insurance.

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Supreme Court allows states to cut Medicaid funding for Planned Parenthood

Healthcare Dive - Practice Management

Plaintiffs argued the executive order violated a federal “free choice of provider clause” that guarantees Medicaid beneficiaries the right to choose their doctor, so long as they are qualified and accept the insurance. Justice Neil Gorsuch, writing the majority opinion, said the law provided no such explicit guarantee.

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Rising Healthcare Costs in 2025: What Providers Can Do to Manage the Impact  

CollaborateMD

The findings also point out that much of the costs result from the burden and time associated with dealing with specific practices that insurers have put in place around prior authorization and delays in payments. Higher prices for medical services, medications, and insurance premiums directly impact patients’ out-of-pocket expenses.

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