Commercial Insurer Accountability
The latest news on health plan accountability from the AHA for June 2022.
AHA today urged the FTC to scrutinize commercial health plans that steer patients to third-party specialty pharmacies in which they have a financial interest.
To help members address the impact of payer prior authorization and payment delays and denials, as well as anticompetitive practices, on patients and provider organizations, the AHA has launched AHA Vitality Index鈩. Learn how this dashboard supplies the commercial payer transparency that hospitals鈥
Policymakers should strengthen Medicare payment rates rather than hold them up as the gold standard, argues Benjamin Finder, AHA鈥檚 director of policy research and analysis.
To help members reduce the significant operational challenges caused by some of these commercial payer issues, the AHA has also launched a new solution, the AHA Vitality Index.
A recent AHA survey of hospitals and health systems found that 89% of respondents experienced an increase in payment denials over the past three years, and 51% reported experiencing a 鈥渟ignificant鈥 increase in denials.
Hospitals and health systems put the health and welfare of their patients first. For some of the nation鈥檚 largest commercial health insurers, unfortunately, that is not always the case.
Anthem, the country鈥檚 second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors because of onerous new reimbursement rules, computer problems and mishandled claims, says a Kaiser Health News article that is spotlighted in USA Today.
Anthem, the country鈥檚 second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors because of onerous new reimbursement rules, computer problems and mishandled claims, says a Kaiser Health News article that is spotlighted in USA Today.
America鈥檚 hospitals and health systems have deep concerns about several Anthem policies that challenge their ability to care for patients during the COVID-19 global pandemic.